Correlation between TIR and cognitive impairment in elderly patients with T2DM

SHUI Min; ZHAO Dewei; WEI Jijie

doi:10.3969/j.issn.1674-3245.2025.05.018

Abstract：Objective To investigate the correlation between TIR and cognitive impairment in elderly patients with T2DM.Methods A total of 80 elderly patients with T2DM admitted to Linquan People's Hospital from May 2023 to July 2024 were reviewed.They were divided into cognitive impairment group(n=36)and normal cognition group(n=44)according to whether they had cognitive impairment.General information,Montreal Cognitive Assessment Scale(MoCA)scores,fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 h PG),glycated hemoglobin(HbA1c)and TIR were compared.The correlation between blood glucose indicators and MoCA score was analyzed.Results Compared with the normal cognition group,the course of T2DM in the cognitive impairment group was longer[(11.47±2.85)years vs(8.39±2.06)years],and total MoCA score was lower[(21.71±3.19)scores vs(27.92±2.85)scores],and HbA1c level was higher[(8.43±1.85)%vs(7.26±1.44)%],and TIR was shorter[(53.72±13.86)%vs(67.93±16.75)%](t=5.603,9.188,3.181,4.074,P<0.05).There was no significant difference in FPG or 2hPG between the two groups(t=0.575,1.174,P>0.05).HbA1c level was negatively correlated with MoCA score(r=-0.302,P=0.006).TIR was positively correlated with MoCA score(r=0.410,P<0.001).FPG and 2 h PG levels were not correlated with MoCA score(P>0.05).Long course of T2DM(OR=1.146,95%CI:1.035～1.269)and high HbA1c level(OR=1.188,95%CI:1.013～1.392)were risk factors for cognitive impairment in elderly patients with T2DM(P<0.05),while high TIR level(OR=0.976,95%CI:0.959～0.994)was a protective factor(P<0.05).Conclusion Cognitive impairment is closely related to TIR in elderly patients with T2DM.The longer the TIR,the better the blood glucose control throughout the day,and the lower the risk of cognitive impairment.