Abstract: Background　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. Objective　To investigate the prevalence of type 2 diabetes mellitus with mild cognitive impairment among the elderly in the Sichuan region，and to identify the factors influencing its occurrence. Methods　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 mild cognitive impairment. Results　A total of 407 questionnaires were distributed，of which 397 were valid，yielding a response rate of 97.54%. Among the 397 participants，351（88.4%）were elderly individuals residing in communities，and 46（11.6%）were from nursing homes. A total of 84 participants were identified with mild cognitive impairment（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，frequency of 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 lower educational attainment（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）. Additionally，within the unbalanced TCM constitution subgroup，the yang deficiency constitution score was negatively correlated with the delayed memory domain score of cognitive function （r=-0.106，P<0.05）. Conclusion　The prevalence of mild cognitive impairment 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.

Key words: Type 2 diabetes mellitus, Mild cognitive impairment, Aged, Root cause analysis, TCM constitutions

摘要： 背景　老年人2型糖尿病高发已经成为全球严峻的公共卫生问题。糖尿病对认知功能损害极大，目前仍缺乏简便指标对其进行早期监测及识别，亟待更多探讨和挖掘。本研究基于真实世界横断面数据分析，从“体病相关”视角下探究该病对临床诊治有一定参考价值。目的　以四川地区为例，探讨老年2型糖尿病患轻度认知障碍的现状及其影响因素。方法　于2021年11月—2023年11月在四川省6个市（成都市、德阳市、巴中市、峨眉山市、眉山市、绵阳市）多个不同社区及3个养老院选取≥60岁老年2型糖尿病患者进行调查。使用纸质问卷进行面对面调查，调查问卷包括基本资料、长沙版蒙特利尔认知评估量表（MoCA）、中医体质评估。采用单因素分析结合多因素Logistic回归分析探究2型糖尿病伴轻度认知障碍的可能独立影响因素。结果　共发放调查问卷407份，回收有效问卷397份，有效回收率为97.54%。397例研究对象包括社区老年人351（88.4%）例，养老院老年人46（11.6%）例；轻度认知障碍患者84例，2型糖尿病伴轻度认知障碍患病率为21.2%。依据患者是否伴轻度认知障碍将其分为2型糖尿病伴轻度认知障碍组（n=84）和2型糖尿病不伴轻度认知障碍组（n=313）。两组患者受教育程度、抑郁、读书看报、气虚质、阳虚质、痰湿质、湿热质比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，低文化程度（初中：OR=0.487，95%CI=0.253~0.939；大学及以上：OR=0.149，95%CI=0.034~0.659）、阳虚质（OR=2.284，95%CI=1.220~4.279）为老年2型糖尿病患者发生轻度认知障碍的独立影响因素（P<0.05）。偏颇体质层面，阳虚质得分与延迟记忆认知域得分呈负相关（r=-0.106，P<0.05）结论　四川省老年2型糖尿病患者轻度认知障碍患病率为21.2%，且低教育程度、阳虚质是发生轻度认知障碍的高危人群。结合中医“体质可分-体病相关-体质可调”理论，针对阳虚者进行早期干预，可能有助于降低糖尿病认知障碍转化。

关键词: 2型糖尿病, 轻度认知功能障碍, 老年人, 影响因素分析, 中医体质