Longitudinal Relationship between Cognitive Function and Health-Related Quality of Life among Middle-Aged and Older Patients with Diabetes in China: Digital Usage Behavior Differences

Abstract

Background: Cognitive function and health-related quality of life (HRQoL) are important issues in diabetes care. According to the China Association for Aging, it is estimated that by 2030, the number of elderly people with dementia in China will reach 22 million. The World Health Organization reports that by 2044, the number of people with diabetes in China is expected to reach 175 million. Methods: Cohort analyses were conducted based on 854 diabetic patients aged ≥45 years from the third (2015) and fourth (2018) survey of the China Health and Retirement Longitudinal Study (CHARLS). Correlation analysis, repeated-measures variance analysis, and cross-lagged panel models were used to measure the difference in digital usage behavior in the established relationship. Results: The results show that the cognitive function of middle-aged and older diabetic patients is positively correlated with HRQoL. HRQoL at T1 could significantly predict cognitive function at T2 (PCS: B = 0.12, p < 0.01; MCS: B = 0.14, p < 0.01). This relationship is more associated with individual performance than digital usage behavior. Conclusions: Unidirectional associations may exist between cognitive function and HRQoL among middle-aged and older Chinese diabetes patients. In the future, doctors and nurses can recognize the lowering of self-perceived HRQoL of middle-aged and older diabetic patients, and thus draw more attention to their cognitive function, in turn strengthening the evaluation, detection, and intervention of their cognitive function.

Perspectives on Aging and Quality of Life

“…A large European study demonstrated that frailty is more common in older adult diabetics, who tend to be depressed in addition to having low self-health ratings [60]. A study of a cohort of diabetic patients in China reported a correlation between cognitive decline and quality of life [61]. Thus, older adult patients with diabetes not only require insulin injections, but also experience a variety of adverse effects that persist throughout their lives and do not improve their HRQOL.…”

The DIKWP (Data, Information, Knowledge, Wisdom, Purpose) Revolution: A New Horizon in Medical Dispute Resolution

“…The doctor-patient relationship is a significant livelihood issue for each stage of social development, characterized by the different attributes of the times. The gradual tension in the doctor-patient relationship can lead to doctor-patient disputes [1], and the reason for this mainly stems from the cognitive differences between doctors and patients [2]. Therefore, easing the tension in doctor-patient relationships [3] and maintaining the regular order of medical services are questions we need to explore.…”

Quality of life profiles and their associations with depressive symptoms and cognitive impairment of community-dwelling older adults in Hong Kong

“…Following the same logic, recent research has consistently demonstrated the predictive role of QoL in cognitive impairment and dementia onset in older adults ( 35 , 39 ). A recent longitudinal study on middle-aged and older Chinese patients with diabetes, showed that participants’ health-related QoL (HRQoL) at Time 1 significantly predicted their cognitive impairment at Time 2 ( 40 ). Although previous mixed findings imply a bidirectional relationship between QoL and cognitive impairment, there is more evidence to support a predictive role of QoL on cognitive impairment.…”