Association of BMI and Cognitive Performance in the Diabetes Prevention Program Outcomes Study

This study aimed to examine the association of BMI with cognitive performance in individuals with diabetes or prediabetes.

Among Diabetes Prevention Program Outcomes Study (DPPOS) participants, BMI was categorized as normal (< 25 kg/m²), overweight (25 to < 30 kg/m²), or obesity (≥ 30 kg/m²). Cognitive tests included the Brief Spanish English Verbal Learning Test (B-SEVLT) and the Digit Symbol Substitution test (DSST). The relationship between BMI at DPPOS Year 8 (Y8) visit and cognitive test scores at Y8, Y10, and Y15 visits was ascertained via linear mixed models accounting for repeated measures. Analogous models related BMI to Modified Mini-Mental State exam (3MS) score at Y15.

A total of 2285 participants (mean ± SD age 51.1 ± 10.0 years; 67.7% female; 31% with overweight; and 60% with obesity at DPPOS Y8) completed cognitive assessments. Those with overweight or obesity at Y8 had a slower decline in B-SEVLT immediate and delayed recall, compared with those with normal BMI; 3MS performance was higher among individuals with overweight or obesity compared to those with normal BMI at Y15.

Among individuals with prediabetes or diabetes in DPPOS, overweight or obesity was associated with slower decline in verbal learning and memory compared with those with normal BMI.