Physical activity may weaken association between cognitive decline and diabetes
Diabetes increased risk for cognitive impairment among inactive but not active adults in a cohort study in Brazil, and active adults with diabetes developed cognitive impairment 2.73 years later, on average, than the inactive diabetes patients.
Patients with diabetes may be less likely to experience cognitive decline if they are physically active, a recent study found.
Researchers used the Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) study to evaluate whether leisure-time physical activity modified the association between diabetes and cognitive decline, comparing data in 2008-2010 and 2017-2019. Global cognitive function was assessed at baseline and at follow-up by adding the scores of six standardized tests for memory and verbal fluency. Incident cognitive impairment was defined as a global cognitive function score that decreased by more than 1 SD from the baseline mean at follow-up. Participants who reported at least 150 minutes of moderate to vigorous leisure-time physical activity per week at baseline were considered physically active. Multivariable regression models were used to assess the association of physical activity and change in global cognition among those with diabetes versus the overall sample. The study results were published Jan. 5 by Diabetes Care.
A total of 12,214 patients participated in the study. Mean age at baseline was 51.4 years, 55.5% were women, 53.0% were White, 23.5% were active, and 14% had diabetes. Mean follow-up was 8.1 years. Overall, the patients who were inactive and who had diabetes at baseline experienced faster decline in global cognition than those who were active and those who did not have diabetes at baseline, respectively. The risk for cognitive impairment was significantly increased in inactive patients with diabetes but not active adults with diabetes (hazard ratios, 1.71 [95% CI, 1.22 to 2.39] vs. 1.18 [95% CI, 0.73 to 1.90]). Active participants with diabetes had a delay of 2.73 years (95% CI, 0.94 to 4.51 years) in onset of cognitive impairment compared with participants with diabetes who were inactive.
The researchers noted that physical activity was self-reported and that confounding could not be ruled out, among other limitations. “In conclusion, our findings reveal that [leisure-time physical activity] may attenuate the rate of cognitive decline in middle-aged and older adults living with diabetes, potentially delaying the onset of cognitive impairment in this population,” they wrote. “Although future studies, including randomized clinical trials, are warranted, our results strengthen the support for a pivotal role of physical activity in mitigating diabetes-related cognitive complications.”