Kim Jeeyeon, Cuevas Heather
Nurs Res. 2024;73(5):381-389. doi: 10.1097/NNR.0000000000000749. Epub 2024 May 20.
Music interventions have beneficial effects on cognitive function and related risk factors, such as depressive symptoms and behavior of exercise participation. However, little research has been conducted on music's effects on people with type 2 diabetes, and evidence of the effect remains inconclusive in this population.
Guided by the theory of music, mood, and movement (MMM), this exploratory study aimed to examine the direct and indirect effects of musical activity engagement, depressive symptoms, and physical activity on cognitive function in people with type 2 diabetes.
The present study is a secondary data analysis using the cross-sectional data collected from the Memory, Attention, and Problem-Solving Skills for Persons With Diabetes trial conducted between 2021 and 2023. Data were collected using self-reported questionnaires and a computerized cognitive assessment tool. A total of 189 people with type 2 diabetes and subjective cognitive decline were included in the study. Path analysis was conducted using IBM SPSS AMOS to examine the pathways of the proposed conceptual framework.
The study results partially support the MMM model for subjective cognitive function but not objective cognitive function. The path model demonstrated the significant direct effects of musical activity engagement on physical activity, physical activity on subjective cognitive function, and depressive symptoms on physical activity as well as on subjective cognitive function. There was a significant indirect effect of musical activity engagement on subjective cognitive function through physical activity-which fully mediated this relationship. However, no significant direct effect of musical activity engagement on depressive symptoms and subjective cognitive function was found.
The findings suggest that regular assessment of the presence of depressive symptoms and physical activity participation should be done in people with type 2 diabetes to identify potential modifiable factors and develop targeted interventions for cognitive health promotion. Also, our findings provide insights into the potential use of music to facilitate physical activity and manage cognitive health in people with type 2 diabetes. This study partially supports the MMM model; however, more research with a rigorous study design and larger sample size is needed to better understand the relationships among musical activity engagement, depressive symptoms, physical activity, and cognitive function.
音乐干预对认知功能及相关风险因素具有有益影响，如抑郁症状和运动参与行为。然而，针对音乐对2型糖尿病患者影响的研究较少，且该人群中其影响的证据仍不明确。
以音乐、情绪和运动（MMM）理论为指导，本探索性研究旨在探讨音乐活动参与、抑郁症状和身体活动对2型糖尿病患者认知功能的直接和间接影响。
本研究是一项二次数据分析，使用了2021年至2023年期间进行的糖尿病患者记忆、注意力和解决问题技能试验所收集的横断面数据。数据通过自我报告问卷和计算机化认知评估工具收集。共有189名患有2型糖尿病且有主观认知衰退的患者纳入研究。使用IBM SPSS AMOS进行路径分析，以检验所提出概念框架的路径。
研究结果部分支持MMM模型对主观认知功能的作用，但不支持对客观认知功能的作用。路径模型显示音乐活动参与对身体活动、身体活动对主观认知功能、抑郁症状对身体活动以及对主观认知功能均有显著直接影响。音乐活动参与通过身体活动对主观认知功能有显著间接影响，身体活动完全介导了这种关系。然而，未发现音乐活动参与对抑郁症状和主观认知功能有显著直接影响。
研究结果表明，应对2型糖尿病患者定期评估抑郁症状的存在情况和身体活动参与情况，以识别潜在的可改变因素，并制定促进认知健康的针对性干预措施。此外，我们的研究结果为音乐在促进2型糖尿病患者身体活动和管理认知健康方面的潜在应用提供了见解。本研究部分支持MMM模型；然而，需要更多设计严谨、样本量更大的研究，以更好地理解音乐活动参与、抑郁症状、身体活动和认知功能之间的关系。
