The global rise in the prevalence of type 2 diabetes mellitus (T2DM) among the elderly has emerged as a significant public health concern. T2DM is known to exert detrimental effects on cognitive function. However, there remains a lack of simple and effective indicators for the early detection and monitoring of this condition, highlighting an urgent need for further investigation. The present study utilizes real-world cross-sectional data to explore the disease from the perspective of "physical disease-related adjustable constitution" offering potential clinical value for the diagnosis and treatment.

To investigate the prevalence of type 2 diabetes mellitus with mild cognitive impairment (MCI) among the elderly in the Sichuan region, and to identify the factors influencing its occurrence.

Elderly patients aged ≥60 years with type 2 diabetes mellitus were selected for the survey conducted from November 2021 to November 2023. The participants were recruited from various communities and three nursing homes across six cities in Sichuan Province, namely Chengdu, Deyang, Bazhong, Emeishan, Meishan, and Mianyang. A face-to-face survey was administered using a paper-based questionnaire, which collected basic demographic information, the Changsha version of the Montreal Cognitive Assessment (MoCA), and the Traditional Chinese Medicine constitution assessment. Univariate analysis, followed by multifactorial Logistic regression, was performed to identify potential independent factors influencing the occurrence of type 2 diabetes mellitus with MCI. Pearson correlation analysis was used to explore the correlation between different cognitive domains and yang deficiency constitution.

A total of 407 questionnaires were distributed, of which 397 were valid, yielding a response rate of 97.54%. Among the 397 participants, 348 (87.7%) were elderly individuals residing in communities, and 49 (12.3%) were from nursing homes. A total of 84 participants were identified with MCI, resulting in a prevalence of 21.2% for T2DM with MCI. Based on cognitive status, participants were divided into two groups: those with T2DM and MCI (n=84) and those with T2DM without MCI (n=313). Statistically significant differences were observed between the two groups in terms of education level, depression, reading books and newspapers, as well as Traditional Chinese Medicine (TCM) constitutions including qi deficiency, yang deficiency, phlegm-dampness, and damp-heat (P<0.05). Multivariate Logistic regression analysis identified educational level (junior high school: OR=0.487, 95%CI=0.253-0.939; university and above: OR=0.149, 95%CI=0.034-0.659) and a yang deficiency constitution (OR=2.284, 95%CI=1.220-4.279) as independent risk factors for MCI in elderly patients with T2DM (P<0.05). The results of the correlation analysis showed that the score of the yang deficiency constitution score was negatively correlated with the delayed memory domain score of cognitive function (r=-0.106, P<0.05).

The prevalence of MCI among elderly patients with type 2 diabetes mellitus in Sichuan Province is 21.2%. Low educational attainment and a yang deficiency constitution are significant risk factors for the development of MCI in this population. In line with the Traditional Chinese Medicine theory that constitution can be differentiated, constitution is related, and constitution can be adjusted, early identification and targeted intervention for yang deficiency constitution may help mitigate the progression of cognitive impairment in patients with diabetes.