Introduction and Objective: Diabetes mellitus (DM) is a major risk factor for cognitive decline and dementia, whereas physical activity (PA) may mitigate this risk. However, the combined effects of PA and DM on cognitive function and brain structure remain unclear. We examined whether PA modifies associations of DM with mild cognitive impairment (MCI) and hippocampal volume in community-dwelling older adults.Methods: We conducted a cross-sectional analysis of 1,615 participants from the Bunkyo Health Study after excluding individuals with a history of depression or dementia. PA was assessed using the IPAQ and classified as moderate-or-higher or low. Participants were categorized into four groups according to PA level and diabetes status. MCI was defined as a MoCA score ≤22, and dementia as a MMSE score ≤23. Hippocampal volume (MRI) was compared using ANCOVA, and odds of MCI/dementia were evaluated using multivariable logistic regression adjusting for demographic, vascular, and lifestyle factors and apolipoprotein E ε4 allele count.Results: The mean age of participants was 73.1±5.4 years, and 57.7% were women. The prevalence of MCI/dementia was 15.6%/2.5% in the non-DM/high PA group, 19.7%/3.9% in the non-DM/low PA group, 20.4%/3.4% in the DM/high PA group, and 38.1%/9.5% in the DM/low PA group. Compared with the non-DM/high PA group, the DM/low PA group showed significantly higher odds of MCI (OR 2.43, 95% CI 1.35-4.37) and dementia (OR 3.42, 1.24-9.38), whereas the non-DM/low PA group (MCI: OR 1.10, 0.80-1.52; dementia: OR 1.15, 0.58-2.28) and the DM/high PA group (MCI: OR 1.05, 0.66-1.68; dementia: OR 1.11, 0.39-3.10) were not. Hippocampal volume was smaller in the DM/low PA group than in the non-DM groups.Conclusion: Low PA combined with DM was associated with cognitive impairment, dementia, and hippocampal atrophy. In contrast, moderate to high PA may help preserve cognitive function and brain structure even among individuals with diabetes.
R. Mori: None. H. Kaga: None. H. Naito: None. H. Tabata: None. E. Takagi: None. T. Kogai: None. S. Sakamoto: None. S. Kakehi: None. H. Watada: Research Support; Current; Sumitomo Pharma Co. Ltd., Sanwa Kagaku Kenkyusho, Kowa Company, Ltd., Taiho Pharmaceutical Co. Ltd., SBI pharma, Boehringer Ingelheim International GmbH. Speaker’s Bureau; Current; Novo Nordisk, Boehringer Ingelheim International GmbH, Sumitomo Pharma Co. Ltd., Lilly, Roche Diagnostics, Merck Sharp & Dohme Corp., Daiichi Sankyo, Kyowa Kirin Co., Ltd., Bayer AG, Abbott Japan Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Teijin Pharma Limited, GlaxoSmithKline plc., Sanofi K.K., embecta. Y. Tamura: Speaker’s Bureau; Current; Ono Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Kowa Research Institute, Inc. Research Support; Ended; Kowa Research Institute, Inc.
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