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The association between physical activity intensity, cognition and brain structure in people with type 2 diabetes

journal contribution
posted on 2023-05-21, 01:06 authored by Zabetian-Targhi, F, Srikanth, VK, Beare, R, Monique BreslinMonique Breslin, Moran, C, Wang, W, Feitong WuFeitong Wu, Kylie SmithKylie Smith, Michele CallisayaMichele Callisaya

Background: Physical inactivity is a risk factor for type 2 diabetes (T2D) and dementia. However, it is unknown if physical activity (PA) intensity is associated with brain health in people with T2D. Therefore, this study aimed to determine 1) associations between PA intensity and step count with both cognition and brain structure and 2) if apolipoprotein E-ε4 (APOE-ε4) or insulin-therapy modifies any associations.

Methods: Participants were people with T2D (n=220; aged 55-86 years). An accelerometer worn over the left hip was used to obtain step count and moderate-to-vigorous PA (MVPA) averaged over 7 days. Cognition in 7 domains was obtained using a battery of neuropsychological tests. Brain structure was measured by Magnetic Resonance Imaging (MRI). Linear regression models were used to examine associations between step count, MVPA and each cognitive and MRI measure. APOE-ε4 x PA and insulin-therapy x PA product terms were added to the models to examine effect modification.

Results: The mean age of participants was 67.9 (SD 6.3). Higher step count was associated with greater hippocampal volume (β=0.028 95%CI 0.005, 0.051). Insulin-therapy modified the association between MVPA and attention-processing speed, such that associations were significant in people receiving insulin-therapy (P for interaction=0.019). There were no other significant associations.

Conclusions: Higher step count and greater time spent in MVPA may be associated with better hippocampal volume and attention-processing speed respectively in people with T2D. People with greater diabetes severity (receiving insulin-therapy) may get more cognitive benefit from MVPA.


Publication title

Journals of Gerontology. Series A: Biological Sciences and Medical Sciences










Menzies Institute for Medical Research


Gerontological Society Amer

Place of publication

1275 K Street Nw Suite 350, Washington, USA, Dc, 20005-4006

Rights statement

© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.

Repository Status

  • Restricted

Socio-economic Objectives

Health related to ageing