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Associations of modifiable lifestyle and clinical factors with cognitive function in adults with type 2 diabetes
Anahita Golchin1, Karen C Johnson2, Denise K Houston1
1Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Aims:
Type 2 diabetes and obesity accelerate cognitive decline. Maintaining salutary levels of multiple lifestyle and clinical risk factors might be expected to protect against this. We examined whether healthier levels of adiposity, cardiorespiratory fitness, physical activity, and diabetes control were associated with better cognitive functioning.
Methods:
Data are from the Action for Health in Diabetes clinical trial of adults with type 2 diabetes and overweight or obesity. Standardized measures of body mass indices, percent body fat, objective and self-reported physical activity, cardiorespiratory fitness, and HbA1c were collected across 4 and 8 years. Associations between healthier versus less healthy levels (categorized based on ± one standard deviation from the cohort mean) of these measures with subsequent standardized (z-scores) assessments of cognitive function were assessed using linear regression.
Results:
Among 3723 participants, high versus low cardiorespiratory fitness was associated with 0.08 to 0.13 standard deviation better global cognitive function, executive function, and attention (p < 0.001). Lower versus high HbA1c was associated with 0.17 to 0.22 standard deviation better cognitive function for all domains (p < 0.001). Associations that fitness and HbA1c had with cognitive function were independent and additive. No significant associations with cognitive function were found for physical activity or adiposity.
Conclusions:
Maintaining greater cardiorespiratory fitness and better diabetes control may protect cognitive function in type 2 diabetes.
Govidentifier:
NCT00017953.
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