Cognitive benefits of a lifestyle-induced prediabetes remission intervention in Canada.

OBJECTIVE

To assess the potential for preventing or reversing the cognitive decline associated with prediabetes and coronary heart disease.

METHODS

In the DIABEPIC-1 feasibility study, participants with coronary heart disease and prediabetes (HbA1c of 5.7% to 6.4%) underwent a 6-month multidisciplinary enhanced cardiac rehabilitation intervention in Canada in 2023. Cognitive performance was assessed at baseline and six months with the Montreal Cognitive Assessment (MoCA), Rey Auditory Learning Verbal Test (RAVLT), Digit Symbol Substitution Test (DSST), Trail Making Test (TMT), Stroop test, and Verbal Fluency (VFT) test. To account for practice effects in the absence of a control group, standardized regression-based (SRB) formulas and reliable change indexes (RCI) were applied.

RESULTS

Thirty participants completed the protocol. Significant improvements were observed in global cognition (MoCA), memory (RAVLT total learning and delayed recall), processing speed (DSST), and executive function (TMT-B, Stroop inhibition and switching, semantic VFT). SRB and RCI analyses showed some participants exceeded expected practice effects in certain cognitive domains. Weight loss was associated with improved processing speed, and reductions in HbA1c were linked to gains in processing speed. Participants achieving prediabetes remission showed greater cognitive improvement.

CONCLUSIONS

These findings suggest potential cognitive benefits of prediabetes remission and support further investigation.