Long-term effects of a multidomain intervention on cognitive function and metabolic control in older adults with type 2 diabetes and mild cognitive impairment: A 42-month follow-up of the J-MIND-Diabetes study.

AIMS: This study investigated the long-term effects of a multidomain intervention on cognition and metabolic control in patients with type 2 diabetes and mild cognitive impairment (MCI).

MATERIALS AND

METHODS

Outpatients aged 70-85 years were randomized to an 18-month multidomain intervention (comprising metabolic/vascular risk management, physical exercise, nutritional counselling, and social activity) or standard diabetes care. Neuropsychological assessments were conducted at 6, 18, 30, and 42 months. Change in the composite cognitive Z-score served as the primary endpoint. Metabolic control was evaluated using continuous glucose monitoring. Between-group differences at 42 months were analysed using mixed-effects models for repeated measures (MMRM).

RESULTS

A total of 42 participants (22 intervention, 20 control) were analysed. The MMRM did not show significant between-group differences in the composite cognitive Z-score at 42 months (0.19; 95% confidence intervals [CI]: -0.14 to 0.52). However, the trail making test part A (-18.0; 95% CI: -28.7 to -7.19) and part B (-26.2; 95% CI: -50.5 to -1.91) showed that the intervention had significant benefits. A significant between-group difference was also observed in the change in %time range 70-180 mg/dL (16.2; 95% CI: 0.96-31.5).

CONCLUSIONS

Multidomain interventions appear to provide sustained benefits for executive function and metabolic control in older adults with type 2 diabetes and MCI. Further studies should be performed to validate these findings.