Abstract
Ageing and diabetes are recognised as important risk factors for the development of cognitive deterioration. The aim was to analyse the effects of a walking-based training programme on cognitive deterioration and glycosylated haemoglobin (HbA1c) in older women with type 2 diabetes. This was a six-month experimental and longitudinal study with an experimental group (EG) (n = 57) and a control group (CG) (n = 52). All participants were diabetic with hypoglycaemic treatment. EG carried out a walking-based training program. After the training, we evaluated the diabetic state (HbA1c), cognitive functioning with the Mini-Mental State Examination (MMSE), cardiorespiratory fitness (VO2max) and body mass index (BMI). Results: EG obtained better results than CG in all the analysed variables. EG showed a significant improvement in the levels of HbA1c (−4.5%; p < 0.001), VO2max (+5.9%; p < 0.001) and BMI (−5.4%; p < 0.001); it also obtained increases in the scores of cognitive functioning, which were statistically significant in all dimensions, except for calculation (p = 0.384) and language (p = 0.168). Conclusion: The aerobic treatment produced significant improvements in the diabetic state and cognitive functioning in older women with type 2 diabetes.
Highlights
Type 2 diabetes mellitus (DM2) represents an important disease burden in terms of morbidity, mortality and disability [1,2], which is associated with states of fragility [3]
We considered the recommendations on the clinical use of the Spanish versions of the Mini-Mental State Examination (MMSE) [33] and we used a total valuation of 30 points and a cutoff score of ≤24 for the diagnosis of pathological suspicion of mild cognitive impairment (MCI) [34]
The aim of this study was to verify whether aerobic physical exercise improves the levels of glycosylated haemoglobin and cognitive functioning in older women diagnosed with type 2 diabetes mellitus
Summary
Type 2 diabetes mellitus (DM2) represents an important disease burden in terms of morbidity, mortality and disability [1,2], which is associated with states of fragility [3]. Changes in lifestyle, nutrition, physical activity and cognitive training decrease the fragility index [7], since it has been reported that cognitive deterioration and/or physical fragility are powerful factors that identify diabetic people with high mortality risk [8]. DM2 patients present greater cognitive impairment, with prevalence of psychiatric disorders [12]. This cognitive fragility, in addition to physical fragility, is more frequent in younger individuals with DM2 than in those without diabetes [13], with the cognitive decrease being more evident in older women with DM2, who generally have a lower education level [14]. Cognitive decline in older individuals with DM2 has been attributed to a decrease in cerebral blood flow, affecting the medial temporal lobe and lower parietal regions [15], to brain network atrophy [16] and to the action of the adipocytokine protein nicotinamide phosphoribosyltransferase, which favours early cognitive damage [17]
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