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European Review of Aging and Physical Activity
Published in: European Review of Aging and Physical Activity 1/2018

Open Access 01-12-2018 | Review Article

Exercise or physical activity and cognitive function in adults with type 2 diabetes, insulin resistance or impaired glucose tolerance: a systematic review

Authors: Ren Ru Zhao, Anthony J. O’Sullivan, Maria A. Fiatarone Singh

Published in: European Review of Aging and Physical Activity | Issue 1/2018

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Abstract

Background

Diabetes is an important risk factor for cognitive impairment. Although some studies suggest that physical exercise can minimize age-related cognitive declines or improve brain morphology or function, benefits in diabetes or impaired glucose tolerance are unclear. Therefore, our aim was to evaluate the efficacy of exercise or physical activity on cognition in adults with type 2 diabetes, insulin resistance or impaired glucose tolerance.

Methods

An electronic search for studies published from the earliest record until February 2017 was conducted using Medline, EMBASE, SPORTDiscus, CINAHL, and PsycINFO. Any experimental or observational study designs were included, as long as they were conducted in individuals of any age with type 2 diabetes, insulin resistance or impaired glucose tolerance, and they directly examined exercise/physical activity effects on cognitive outcomes or the relationship between changes in cognition and changes in either insulin resistance and glucose homeostasis. Study quality was assessed using the PEDro scale; data on participant and intervention characteristics and outcomes were extracted.

Results

Six studies enrolling 2289 participants met the eligibility criteria. Quality was modest and effect sizes variable and mostly small or negligible. Overall, four of the six studies (67%) reported significant benefits of greater exercise/physical activity participation for some aspects of cognition, but only 26% of cognitive outcomes were significant across all trials. Clinical improvements in insulin resistance/glucose homeostasis were related to improvements in cognitive function in three studies. Overall results were inconsistent, with benefits varying across exercise types and cognitive domains.

Conclusions

Literature does not provide evidence that physical activity or exercise interventions contribute to a better cognitive function in patients with type 2 diabetes or impaired glucose tolerance. Large-scale, long-term, robust randomized controlled trials are required to determine if exercise improves cognition in this high-risk cohort, and to investigate putative mechanistic links between cognition, body composition, metabolism, and inflammation in diabetes and related metabolic syndromes.
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Metadata
Title
Exercise or physical activity and cognitive function in adults with type 2 diabetes, insulin resistance or impaired glucose tolerance: a systematic review
Authors
Ren Ru Zhao
Anthony J. O’Sullivan
Maria A. Fiatarone Singh
Publication date
01-12-2018
Publisher
BioMed Central
Published in
European Review of Aging and Physical Activity / Issue 1/2018
Print ISSN: 1813-7253
Electronic ISSN: 1861-6909
DOI
https://doi.org/10.1186/s11556-018-0190-1

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