The effects of an exercise and lifestyle intervention program on cardiovascular, metabolic factors and cognitive performance in middle-aged adults with type II diabetes: a pilot study.
BACKGROUND
Canada is experiencing a rise in type II diabetes mellitus (T2DM), a known risk factor for accelerated cognitive decline and dementia. Within the context of an aging population, this will impose significant individual and societal burden, making the development of prevention programs imperative.


OBJECTIVE
This pilot study examines the effects of the Diabetes Exercise and Healthy Lifestyle Service, a 24-week intervention program, on cardiovascular, metabolic regulation and cognitive function in adults with T2DM.


METHODS
Seventeen middle-aged participants provided blood samples for biological markers, underwent cognitive testing and a physical stress test pre- and post-intervention. Cognitive performance was evaluated using the California Verbal Learning Test (CVLT), Digit Symbol Substitution Tasl (DSST) and fluency test.


RESULTS
Adjusted models reveal participants displayed increased cardiovascular fitness (VO2 peak: Mchange=4.09 mL∙kg∙min(-1) SE=1.4), peak heart rate (Mchange= 9.28 beats⋅min(-1) SE=2.68) and change in heart rate (Mchange=10.71 SE=1.76) in response to the stress test (ps<0.05) following the 24-week intervention. A decrease in body mass index (BMI) (Mchange= -1.03 SE=0.40) and depressive symptomatology (CES-D: Mchange = -3.62 SE=1.44) was also found (ps<0.05). No change was found for lipid and glucose levels. Surprisingly, analyses showed that cognitive performance on the CVLT immediate recall (M= -4.37 SE=2.21), CVTL short-delay recall (M= -1.06 SE=0.55), DSST (Mchange= -3 SE=0.53) and category fluency (Mchange= -1.69 SE=0.78) declined following the intervention (ps<0.05); however, decline on the CVLT was limited to adults with co-morbid T2DM and hypertension.


CONCLUSIONS
Additional research is needed to evaluate the benefit of an exercise and lifestyle program that targets cognitive health in those with T2DM.
Department of Psychology, Ryerson University, Toronto, Ontario, Canada. Electronic address: afiocco@psych.ryerson.ca.
Alexandra Jasmine
AJ
Fiocco
Department of Psychology, York University, Toronto, Ontario, Canada.
Sabrina
S
Scarcello
Toronto Rehab Institute, University Health Network, Toronto, Ontario, Canada.
Susan
S
Marzolini
Toronto Rehab Institute, University Health Network, Toronto, Ontario, Canada.
Alan
A
Chan
Toronto Rehab Institute, University Health Network, Toronto, Ontario, Canada.
Paul
P
Oh
Department of Psychology, York University, Toronto, Ontario, Canada.
Guy
G
Proulx
Rotman Research Institute, Baycrest, Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
Carol
C
Greenwood
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D003071:Cognition / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011314:Preventive Health Services / Q000379:methods*; D011581:Psychological Tests
cognition; diabète sucré de type II; intervention sur le mode de vie; lifestyle intervention; type II diabetes mellitus