Relationship Between Physical Exercise and Cognitive Impairment Among Older Adults with Type 2 Diabetes: Chain Mediating Roles of Sleep Quality and Depression

• Published in: Psychology research and behavior management Vol. 16; pp. 817 - 828
• Main Authors: Zhang, Han, Zhang, Yefan, Sheng, Sen, Xing, Yang, Mou, Zhongchen, Zhang, Yanqiu, Shi, Zhixue, Yu, Zhenjie, Gao, Qianqian, Cai, Weiqin, Jing, Qi
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 2023; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Aged; Analysis; Cognitive ability; cognitive impairment; depression; Depression, Mental; Diabetes; Executive function; Exercise; Glucose; Hypotheses; Insulin resistance; Jurisdiction; Memory; Mental depression; older adults; Older people; Original Research; physical exercise; Physiological aspects; Population; Self report; Sleep disorders; sleep quality; Type 2 diabetes; Canada; China; older adults; cognitive impairment; type 2 diabetes; depression; physical exercise; sleep quality
• ISSN: 1179-1578; 1179-1578
• DOI: 10.2147/PRBM.S403788

Although physical exercise has been shown to boost physical, psychological, and psychiatric conditions in older adults, there is a relative lack of research on the mechanisms involved in this process for older adults with type 2 diabetes mellitus (T2DM). We thus evaluated whether sleep quality and depression mediated the relationship between physical exercise and cognitive impairment in older adults with T2DM by focusing on the exercise-physiology-psychology and psychiatry connection. Self-reported data were collected from 2646 older adults with T2DM in Weifang, Shandong, China. Regression and bootstrap analyses were conducted to explore the chain mediator model including physical exercise, cognitive impairment, sleep quality, and depression. Engaging in physical exercise (coefficient = -0.6858, < 0.001), high levels of sleep quality (coefficient = -0.3397, = 0.015), and low levels of depression (coefficient = 0.3866, < 0.001) were significantly associated with a low level of cognitive impairment. Sleep quality and depression mediated the chain effect between physical exercise and cognitive impairment (total effect = -1.0732, 95% CI [-1.3652, -0.7862]; direct effect = -0.6858, 95% CI [-0.9702, -0.3974]; indirect effect = -0.3875, 95% CI [-0.5369, -0.2521]). Physical exercise may improve sleep quality in older adults with T2DM, alleviating depression and delaying the development of cognitive impairment. Physical exercise can enhance patients' ability to resist depression and cognitive impairment, and creating comfortable sleep environments can also reinforce the effects of this process. These findings have important implications for promoting healthy aging in older adults with T2DM.