Aim To examine the association between continuous glucose monitoring (CGM)‐derived metrics and cognitive performance in older adults with type 2 diabetes (T2D). Materials and methods A total of 100 outpatients with T2D aged 70 years or older were analysed. Participants underwent CGM for 14 days. As CGM‐derived metrics, mean sensor glucose (SG), glucose coefficient of variation (CV), time in range (TIR; 70‐180 mg/dl), time above range (TAR; > 180 mg/dl) and time below range (TBR; < 70 mg/dl), were calculated. Participants underwent cognitive tests, including the Japanese version of the Montreal Cognitive Assessment (MoCA‐J), a delayed word‐recall test from the Alzheimer's Disease Assessment Scale‐cognitive subscale, a digit symbol substitution test, a letter word fluency test, a trail‐making test (TMT) and digit span test (DSP). Results In multiple regression analyses adjusted for confounders, a higher mean SG was associated with a lower performance in MoCA‐J and TMT part B (TMT‐B) (P < .05). A higher TAR was associated with a lower performance in TMT‐B and DSP‐backward (P < .05). By contrast, a higher TIR was associated with better function in TMT‐B and DSP‐backward (P < .05). Furthermore, CV and TBR were not associated with any cognitive function. Conclusion Hyperglycaemia metrics and TIR derived from CGM are associated with cognitive functions, especially with executive function and working memory, in older adults with T2D.

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ObjectivePreventive measures to limit the spread of COVID-19 are essential, but often cause social isolation, affecting the physical and mental health of older adults. Patients with dementia are likely to have worsening behavioral and psychological symptoms of dementia (BPSD) owing to pandemic restrictions. To examine this, we described BPSD before and during the COVID-19 pandemic.MethodsWe identified patients at a memory clinic in Japan between October 2018 and December 2019 (15 months before the pandemic began, n = 1,384) and between April 2020 and June 2021 (15 months after the State of Emergency was declared; n = 675 patients). A propensity score was used to match 576 patients from each group. The Mini-Mental State Exam was used to classify cognitive function into mild and moderate/severe. Dementia Behavioral Disturbance Scale was used to evaluate BPSD. The association between BPSD before and during the pandemic was evaluated using binomial logistic regression models.ResultsThe levels of frequent night waking were higher in individuals before the pandemic than in those evaluated during the pandemic in both the mild group [adjusted odds ratio (AOR) = 1.82, 95% CI 1.02–3.23] and the moderate/severe group (AOR = 1.96, 95% CI 1.19–3.23). During the pandemic, physical attacks were higher in the mild group (AOR = 4.25, 95% CI 1.12–16.07), while night wandering was higher in the moderate/severe group (AOR = 2.22, 95% CI 1.03–4.81).ConclusionIn patients with cognitive impairment, some BPSD were more prevalent during the pandemic, depending on dementia severity. The findings pertaining to the higher frequency of sleep disturbance and aggressiveness during COVID-19 should be used to guide BPSD screening in patients with dementia and to provide evidence-based interventions.

Psychological resilience refers to the ability to cope with adversities, and deficits in resilience might lead to mental illness. The COVID-19 pandemic has had impact on psychological resilience for older adults, but there are as yet no data on its impacts on the mental health of older adults who were living with mild cognitive impairment (MCI). Therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic on psychological resilience in older adults with MCI and to explore associated physical and psychosocial factors. In this cross-sectional study of 268 older adults aged 65–85, we defined MCI as age- and education-adjusted cognitive decline with a standard deviation of 1.0 or more from the reference threshold. During December 2020 to April 2021, we carried out to all participants the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC-10) to measure psychological resilience. We also conducted a comprehensive geriatric assessment including sleep quality and depressive symptoms (Pittsburgh Sleep Quality Index and 15-item Geriatric Depression Scale, respectively). To identify factors associated with CD-RISC-10 scores (mean: 23.3 ± 0.4), multiple regression analysis revealed that older age [coefficient = 0.23, 95% confidence interval (CI) = 0.06–0.39] was significantly correlated with higher scores, whereas poor sleep quality (coefficient = −2.06, 95% CI = −3.93 to −0.19) and depressive symptoms (coefficient = −2.95, 95% CI = −5.70 to −0.21) were significantly correlated with lower scores. In this study, older adults with MCI showed low psychological resilience during the COVID-19 pandemic, and people with low psychological resilience indicated poor sleep quality and depressive symptoms. Our findings suggest directions for devising interventions to maintain mental health and psychological resilience among the vulnerable population of older adults with MCI living under the socially isolated conditions of COVID-19 pandemic restrictions. Our recommendation includes continuous assessment of this population and appropriate care for poor sleep quality and depressive symptoms.