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. 2025 Jun 15;16(6):105496.
doi: 10.4239/wjd.v16.i6.105496.

Does low physical activity cause cognitive decline in elderly type 2 diabetes patients: A propensity score matching analysis

Yi-Xin Ma  1 , Jing Li  1 , Si-Cong Si  1 , Huan Zhao  1 , Jia Liu  1 , Long-Feng Lv  1 , Kai Yang  1 , Wei Yang  2
Affiliations

Does low physical activity cause cognitive decline in elderly type 2 diabetes patients: A propensity score matching analysis

Yi-Xin Ma et al. World J Diabetes. .

Abstract

Background: The relationship between low physical activity and cognitive impairment in type 2 diabetes mellitus (T2DM) patients remains unclear.

Aim: To explore this association and identify risk factors for cognitive impairment in elderly T2DM patients.

Methods: A retrospective analysis was conducted on 245 elderly T2DM patients treated at Xuanwu Hospital, Beijing, in 2023. Patients were categorized into low physical activity (n = 126) and non-low physical activity (n = 119) groups. After propensity score matching (PSM) of 100 pairs, univariate and binary logistic regression analyses identified risk factors for cognitive impairment. A predictive model was constructed and evaluated using receiver operating characteristic curve analysis.

Results: Before PSM, the percentage of cognitive impairment was higher in the low physical activity group (P < 0.05), but after PSM, this difference was not significant (P > 0.05). Additionally, on regression analyses after PSM, age, occupation type, history of stroke, malnutrition, and frailty remained independent factors associated with cognitive impairment, while low physical activity did not. The constructed risk prediction model for cognitive impairment in elderly T2DM patients exhibited an area under the curve of 0.77.

Conclusion: Low physical activity was not associated with cognitive impairment in our study population. Some results differed before and after PSM analysis, indicating that PSM supports objective assessment of risk factors by controlling for selection bias and confounding factors related to population characteristics. The constructed cognitive risk model provides insight for the development of a clinical tool for early prevention of cognitive impairment in elderly T2DM patients.

Keywords: Cognitive impairment; Low physical activity; Propensity score matching; Type 2 diabetes mellitus.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The flow diagram of the study. T2DM: Type 2 diabetes mellitus; PSM: Propensity score matching; ROC: Receiver operating characteristic.
Figure 2
Figure 2
Receiver operating characteristic curve analysis of the performance of the developed risk model for cognitive decline in elderly type 2 diabetes mellitus patients.
Figure 3
Figure 3
Predictive model for cognitive function using age, occupation type, mini nutritional assessment, instrumental activities of daily living, and stroke history. AUC: Area under the curve.
See this image and copyright information in PMC

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