The relationship between exercise and cognition in diabetes mellitus
Access status:
Open Access
Type
ThesisThesis type
Doctor of PhilosophyAuthor/s
Zhao, Ren RuAbstract
The increasing prevalence and incidence of type 2 diabetes mellitus (T2D) has been referred to as a global epidemic. This thesis aimed to synthesise the evidence base in both animal models and human studies that exercise exposure is related to better cognition in diabetes, via 2 ...
See moreThe increasing prevalence and incidence of type 2 diabetes mellitus (T2D) has been referred to as a global epidemic. This thesis aimed to synthesise the evidence base in both animal models and human studies that exercise exposure is related to better cognition in diabetes, via 2 systematic reviews. Secondly, we investigated the efficacy of a novel form of exercise, POWER training (high velocity PRT), for cognitive function in this cohort. We hypothesised that 12 months of high intensity POWER training would significantly improve cognitive function in a cohort of older adults with T2D and multiple co-morbidities. The GREAT2DO study was the first RCT to evaluate the effects of a one-year intervention of POWER training compared to a SHAM exercise control condition on insulin resistance, HbA1c, body composition, physical performance, inflammation, adipokines, cardiovascular health status, and quality of life as well as to explore relationships between these domains in response to the intervention in this cohort. In this GREAT2DO cognitive sub-study, we assessed global cognition and several cognitive domains at baseline in relation to physical and psychological health, fitness and functional performance, as well as changes over time in cognitive outcomes in response to the intervention. We found that cognitive function improved in both POWER and sham exercise groups over time, although unexpectedly without group effect. However, we showed for the first time that there were significant direct relationships between increases in skeletal muscle mass, total muscle strength, total static balance time, and total adiponectin levels and improvements in cognitive function, and that these relationships only existed in the POWER group, as hypothesised. There is need for further study, in particular exploration of the persistence, clinical relevance, and mechanisms underlying attenuation of the rate of cognitive decline and incident dementia in this high-risk cohort.
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See moreThe increasing prevalence and incidence of type 2 diabetes mellitus (T2D) has been referred to as a global epidemic. This thesis aimed to synthesise the evidence base in both animal models and human studies that exercise exposure is related to better cognition in diabetes, via 2 systematic reviews. Secondly, we investigated the efficacy of a novel form of exercise, POWER training (high velocity PRT), for cognitive function in this cohort. We hypothesised that 12 months of high intensity POWER training would significantly improve cognitive function in a cohort of older adults with T2D and multiple co-morbidities. The GREAT2DO study was the first RCT to evaluate the effects of a one-year intervention of POWER training compared to a SHAM exercise control condition on insulin resistance, HbA1c, body composition, physical performance, inflammation, adipokines, cardiovascular health status, and quality of life as well as to explore relationships between these domains in response to the intervention in this cohort. In this GREAT2DO cognitive sub-study, we assessed global cognition and several cognitive domains at baseline in relation to physical and psychological health, fitness and functional performance, as well as changes over time in cognitive outcomes in response to the intervention. We found that cognitive function improved in both POWER and sham exercise groups over time, although unexpectedly without group effect. However, we showed for the first time that there were significant direct relationships between increases in skeletal muscle mass, total muscle strength, total static balance time, and total adiponectin levels and improvements in cognitive function, and that these relationships only existed in the POWER group, as hypothesised. There is need for further study, in particular exploration of the persistence, clinical relevance, and mechanisms underlying attenuation of the rate of cognitive decline and incident dementia in this high-risk cohort.
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Date
2014-12-31Faculty/School
Faculty of Health SciencesAwarding institution
The University of SydneyShare