Predictors of Subjective Cognitive Decline Among People With Diabetes: Data From the Behavioral Risk Factor Surveillance System

Musical Activity Engagement, Depressive Symptoms, Physical Activity, and Cognitive Function in People With Type 2 Diabetes

BACKGROUND

Music interventions have beneficial effects on cognitive function and related risk factors, such as depressive symptoms and behavior of exercise participation. However, little research has been conducted on music's effects on people with type 2 diabetes, and evidence of the effect remains inconclusive in this population.

OBJECTIVES

Guided by the theory of music, mood, and movement (MMM), this exploratory study aimed to examine the direct and indirect effects of musical activity engagement, depressive symptoms, and physical activity on cognitive function in people with type 2 diabetes.

METHODS

The present study is a secondary data analysis using the cross-sectional data collected from the Memory, Attention, and Problem-Solving Skills for Persons With Diabetes trial conducted between 2021 and 2023. Data were collected using self-reported questionnaires and a computerized cognitive assessment tool. A total of 189 people with type 2 diabetes and subjective cognitive decline were included in the study. Path analysis was conducted using IBM SPSS AMOS to examine the pathways of the proposed conceptual framework.

RESULTS

The study results partially support the MMM model for subjective cognitive function but not objective cognitive function. The path model demonstrated the significant direct effects of musical activity engagement on physical activity, physical activity on subjective cognitive function, and depressive symptoms on physical activity as well as on subjective cognitive function. There was a significant indirect effect of musical activity engagement on subjective cognitive function through physical activity-which fully mediated this relationship. However, no significant direct effect of musical activity engagement on depressive symptoms and subjective cognitive function was found.

DISCUSSION

The findings suggest that regular assessment of the presence of depressive symptoms and physical activity participation should be done in people with type 2 diabetes to identify potential modifiable factors and develop targeted interventions for cognitive health promotion. Also, our findings provide insights into the potential use of music to facilitate physical activity and manage cognitive health in people with type 2 diabetes. This study partially supports the MMM model; however, more research with a rigorous study design and larger sample size is needed to better understand the relationships among musical activity engagement, depressive symptoms, physical activity, and cognitive function.

Effect of visual impairment on subjective cognitive decline in older adults: a cross-sectional study in China

OBJECTIVE

People with visual impairment have more functional limitations associated with subjective cognitive decline (SCD), and those with SCD are extremely susceptible to transitioning to irreversible cognitive impairment. This study aimed to explore if visual impairment is a significant predictor of SCD compared with other socioeconomic and health factors associated with SCD.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

The investigation aimed to assess the factors influencing SCD among 428 participants aged 60 and above in Zhaoyuan, China.

PRIMARY OUTCOME MEASURES

The primary outcome variable was SCD, measured by the Chinese version of SCD questionnaire. Multiple logistic regression and propensity score matching (PSM) were used to analyse the influence of visual impairment on the subjective cognition of the elderly.32.2% of the elderly were experiencing SCD. Older adults with SCD showed a higher prevalence of visual impairment (72.5%) than the elderly without SCD (58.6%) (P=0.006). Multivariate logistic regression analysis showed that bad self-reported health status, lack of physical exercise and visual impairment were the risk factors for SCD in older adults, while more than 9 years of education was a protective factor. In addition, PSM model showed that after eliminating the dominant biases caused by the individual observable heterogeneity of older adults with and without visual impairment, the risk of SCD in the elderly with visual impairment was increased by 13.6%-14.5% and the difference was statistically significant (P<0.05).

CONCLUSIONS

It was found that older adults experiencing visual impairments are at an elevated risk of developing SCD compared with their counterparts without such impairments. Additionally, visual impairment remains a significant risk factor for SCD in the elderly, even adjusting for potential biases arising from individual observable heterogeneity.

Recent contributions to the field of subjective cognitive decline in aging: A literature review

Subjective cognitive decline (SCD) is defined as self-experienced, persistent concerns of decline in cognitive capacity in the context of normal performance on objective cognitive measures. Although SCD was initially thought to represent the "worried well," these concerns can be linked to subtle brain changes prior to changes in objective cognitive performance and, therefore, in some individuals, SCD may represent the early stages of an underlying neurodegenerative disease process (e.g., Alzheimer's disease). The field of SCD research has expanded rapidly over the years, and this review aims to provide an update on new advances in, and contributions to, the field of SCD in key areas and themes identified by researchers in this field as particularly important and impactful. First, we highlight recent studies examining sociodemographic and genetic risk factors for SCD, including explorations of SCD across racial and ethnic minoritized groups, and examinations of sex and gender considerations. Next, we review new findings on relationships between SCD and in vivo markers of pathophysiology, utilizing neuroimaging and biofluid data, as well as associations between SCD and objective cognitive tests and neuropsychiatric measures. Finally, we summarize recent work on interventions for SCD and areas of future growth in the field of SCD.

Diabetes Prevalence, Risk Factors, and Care in Asian American and Pacific Islanders of Texas: Data From the 2015-2019 Behavioral Risk Factors Surveillance System

PURPOSE

The purpose of this study was to investigate the health status and needs of the Asian American/Pacific Islander (AAPI) population with diabetes in Texas.

METHODS

This was a cross-sectional secondary analysis of data collected from the Behavioral Risk Factors Surveillance System in Texas from 2015 to 2019 for non-Hispanic White (NHW) and AAPI adults.

RESULTS

Although the overall crude diabetes prevalence was lower in AAPI adults, age-adjusted diabetes prevalence was higher than in NHWs. Significant risk factors associated with diabetes in the AAPI group included being male, marital status, lower education levels, lower income, being overweight/obese, and having a sedentary lifestyle. Engagement in self-management activities (checking blood glucose, checking feet, attending a diabetes management course) was lower in AAPIs than in NHWs.

CONCLUSIONS

Given stiff barriers to adequate screening and self-management support in diabetes care among ethnic populations such as AAPIs, targeted efforts to improve diabetes screening and effective care are warranted. Because today's AAPI populations are predominantly first-generation immigrant groups who suffer from language barriers, efforts should be made to develop health surveys in multiple languages for wider inclusion of understudied groups like AAPIs in diabetes-related research.