Changes in Cognition and Brain Function After 26 Weeks of Progressive Resistance Training in Older Adults at Risk for Diabetes: A Pilot Randomized Controlled Trial

Introduction Type 2 diabetes is associated with deficits in cognition and brain health. Individuals with 1 or more risk factors for diabetes (i.e., obesity, prediabetes) already experience some neurocognitive impairment and are at risk for further decline. One way to combat these deficits is through exercise; however, whether resistance exercise can improve these functions in this at-risk group is unknown. Methods This study was a pilot randomized controlled trial. Participants were aged 60-80 and had prediabetes (fasting capillary glucose 6.1-6.9 mmol/L) and/or were overweight or obese (body mass index of 25 or above). Participants completed resistance training or balance and stretching exercise (control) thrice-weekly for 6 months. Neuropsychological tests were used to assess cognitive ability, while functional magnetic resonance imaging was used to examine brain activation patterns. Results Resistance training led to improvements in task-switching, attention, and conflict resolution, as well as improved patterns of brain activation that may mimic healthy older adults. Conclusions Resistance exercise may serve as an effective behavioural strategy to improve neurocognition in older adults at risk for type 2 diabetes. A large-scale powered trial is needed to further explore these findings.