PMID- 36960417 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230325 IS - 1179-1578 (Print) IS - 1179-1578 (Electronic) IS - 1179-1578 (Linking) VI - 16 DP - 2023 TI - Relationship Between Physical Exercise and Cognitive Impairment Among Older Adults with Type 2 Diabetes: Chain Mediating Roles of Sleep Quality and Depression. PG - 817-828 LID - 10.2147/PRBM.S403788 [doi] AB - OBJECTIVE: 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. METHODS: 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. RESULTS: Engaging in physical exercise (coefficient = -0.6858, p < 0.001), high levels of sleep quality (coefficient = -0.3397, p = 0.015), and low levels of depression (coefficient = 0.3866, p < 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]). CONCLUSION: 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. CI - (c) 2023 Zhang et al. FAU - Zhang, Han AU - Zhang H AUID- ORCID: 0000-0001-8889-1327 AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. FAU - Zhang, Yefan AU - Zhang Y AUID- ORCID: 0000-0001-7802-6102 AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. FAU - Sheng, Sen AU - Sheng S AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. FAU - Xing, Yang AU - Xing Y AD - Weifang People's Hospital, Weifang, People's Republic of China. FAU - Mou, Zhongchen AU - Mou Z AUID- ORCID: 0000-0003-3749-1854 AD - School of Psychology, Weifang Medical University, Weifang, People's Republic of China. FAU - Zhang, Yanqiu AU - Zhang Y AUID- ORCID: 0000-0003-0759-1758 AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. FAU - Shi, Zhixue AU - Shi Z AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. FAU - Yu, Zhenjie AU - Yu Z AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. FAU - Gao, Qianqian AU - Gao Q AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. FAU - Cai, Weiqin AU - Cai W AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. FAU - Jing, Qi AU - Jing Q AUID- ORCID: 0000-0003-3562-7551 AD - School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China. AD - "Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People's Republic of China. AD - China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People's Republic of China. LA - eng PT - Journal Article DEP - 20230317 PL - New Zealand TA - Psychol Res Behav Manag JT - Psychology research and behavior management JID - 101514563 PMC - PMC10030003 OTO - NOTNLM OT - cognitive impairment OT - depression OT - older adults OT - physical exercise OT - sleep quality OT - type 2 diabetes COIS- All authors declare that they have no conflicts of interest. EDAT- 2023/03/25 06:00 MHDA- 2023/03/25 06:01 PMCR- 2023/03/17 CRDT- 2023/03/24 02:30 PHST- 2023/01/06 00:00 [received] PHST- 2023/03/10 00:00 [accepted] PHST- 2023/03/24 02:30 [entrez] PHST- 2023/03/25 06:00 [pubmed] PHST- 2023/03/25 06:01 [medline] PHST- 2023/03/17 00:00 [pmc-release] AID - 403788 [pii] AID - 10.2147/PRBM.S403788 [doi] PST - epublish SO - Psychol Res Behav Manag. 2023 Mar 17;16:817-828. doi: 10.2147/PRBM.S403788. eCollection 2023.