Department of Mathematics, Winston-Salem State University, 601 S. Martin Luther King Jr. Drive, Winston-Salem, NC 27110, United States of America.
Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States of America.
J Diabetes Complications. 2021 May;35(5):107909. doi: 10.1016/j.jdiacomp.2021.107909. Epub 2021 Mar 16.
To assess whether there is an opportune window when intensive lifestyle intervention (ILI) benefits cognitive function.
Standardized cognitive assessments were collected following ≥8 years of either ILI or a control condition of diabetes support and education (DSE) in 3708 individuals, ages 45-76 years at enrollment, with type 2 diabetes and overweight or obesity. Frailty index (FI) scores were used to group individuals at baseline into tertiles according to their age-related health status. Linear models were used to describe intervention adherence and cognitive function, with interaction terms to examine the consistency of relationships among tertiles.
Worse baseline FI scores were associated with poorer subsequent performance in tests of attention, processing speed, and executive function. No differences in any measure of cognitive function were observed between intervention groups within any FI tertile (all p > 0.10). Among individuals with worse baseline FI scores, weight gain was associated with poorer global cognitive function among participants assigned to DSE. There was no association between weight changes and cognitive function among participants assigned to ILI.
Among adults with type 2 diabetes and overweight/obesity, we found no evidence that there is a window of opportunity based on FI when ILI benefits cognitive function.
评估强化生活方式干预（ILI）是否有益认知功能的适当窗口期。
在 3708 名年龄在 45-76 岁、患有 2 型糖尿病和超重或肥胖的个体中，随访≥8 年，分别接受 ILI 或糖尿病支持和教育（DSE）对照条件，收集标准化认知评估。使用衰弱指数（FI）评分将个体在基线时根据其与年龄相关的健康状况分为三分位组。使用线性模型描述干预依从性和认知功能，并使用交互项来检查三分位组之间关系的一致性。
基线 FI 评分较差与注意力、处理速度和执行功能测试的后续表现较差相关。在任何 FI 三分位组中，干预组之间的任何认知功能测量均无差异（均 p>0.10）。在基线 FI 评分较差的个体中，与 DSE 组参与者相比，体重增加与较差的总体认知功能相关。在接受 ILI 分配的参与者中，体重变化与认知功能之间没有关联。
在患有 2 型糖尿病和超重/肥胖的成年人中，我们没有发现基于 FI 的认知功能 ILI 有益的机会窗口的证据。
