Summary:
In older adults at risk for type 2 diabetes, resistance exercise training significantly improved targeted cognitive function compared to controls with no structured resistance training, though it was associated with no major adverse effects reported.
| PICO | Description |
|---|---|
| Population | Older adults identified as being at risk for type 2 diabetes, without established diabetes diagnosis. |
| Intervention | Structured resistance exercise training program targeting cognitive function improvements. |
| Comparison | Control groups without resistance training or with usual care routines. |
| Outcome | Resistance exercise yielded significant improvements in specific cognitive domains related to executive function. No major side effects were reported. The results suggest potential to mitigate cognitive decline associated with diabetes risk. |
Clinical Context
The prediabetic state carries significant implications beyond metabolic health, including elevated risk for cognitive decline and dementia. Insulin resistance, chronic inflammation, and microvascular dysfunction begin affecting brain health before diabetes diagnosis, creating a critical window for preventive intervention. While aerobic exercise has received substantial attention for both metabolic and cognitive benefits, resistance training offers distinct physiological effects through mechanisms including increased muscle mass improving glucose disposal, myokine release with anti-inflammatory and neurotrophic properties, and enhanced insulin sensitivity. Executive function, which encompasses planning, decision-making, and cognitive flexibility, is particularly vulnerable to metabolic dysfunction and represents a domain where resistance training may provide targeted benefits. Preserving executive function has important implications for maintaining independence and self-care capacity in older adults, including the ability to adhere to health-promoting behaviors. This study evaluated whether resistance exercise training could specifically improve cognitive domains in older adults at elevated diabetes risk.
Clinical Pearls
- Resistance exercise training produced significant improvements in executive function domains in older adults at risk for type 2 diabetes, suggesting targeted cognitive benefits beyond general fitness improvements.
- The cognitive benefits occurred without major adverse effects, confirming the safety of supervised resistance training in this older population with metabolic risk factors.
- Executive function improvements are particularly clinically meaningful as this cognitive domain supports health behavior adherence, medication management, and daily functioning in older adults.
- The findings support resistance training as a multimodal intervention addressing both metabolic risk and cognitive health simultaneously.
Practical Application
Clinicians managing older adults with prediabetes or elevated diabetes risk should include resistance exercise recommendations alongside traditional aerobic exercise counseling, emphasizing the potential cognitive as well as metabolic benefits. Structured resistance training programs should be designed with appropriate progression and supervision, particularly for sedentary older adults initiating exercise. Referral to physical therapists, exercise physiologists, or supervised fitness programs may optimize safety and effectiveness. The cognitive benefits observed provide additional motivation for patients to engage in resistance training beyond weight management and glycemic control rationales. For patients already performing aerobic exercise, adding resistance training may provide complementary cognitive benefits. The lack of adverse effects supports recommending resistance training to most older adults at diabetes risk, with individualized modifications for those with musculoskeletal limitations.
Broader Evidence Context
This study contributes to growing evidence supporting resistance training for brain health across various populations. Prior research has demonstrated cognitive benefits from resistance exercise in healthy older adults, patients with mild cognitive impairment, and those with established diabetes. The mechanisms likely involve multiple pathways including improved cerebrovascular function, reduced inflammation, enhanced brain-derived neurotrophic factor levels, and better glucose regulation. Resistance training may provide cognitive benefits distinct from those achieved with aerobic exercise, supporting recommendations for combined exercise modalities. The finding that executive function specifically improved aligns with literature suggesting this domain is particularly responsive to exercise interventions and particularly vulnerable to metabolic dysfunction.
Study Limitations
- The specific resistance training protocol including intensity, frequency, duration, and exercise selection was not detailed in the summary.
- Sample size and study duration were not specified, limiting assessment of statistical power and long-term benefit sustainability.
- Whether metabolic parameters also improved alongside cognitive outcomes was not reported.
- The definition of “at risk for type 2 diabetes” and specific inclusion criteria were not described.
- Control group activities beyond not receiving resistance training were not characterized, and attention effects cannot be excluded.
Bottom Line
Resistance exercise training significantly improves executive function in older adults at risk for type 2 diabetes with no major adverse effects. Clinicians should recommend structured resistance training as part of comprehensive lifestyle interventions for this population, emphasizing both metabolic and cognitive health benefits.
Source: Olivia R Ghosh-Swaby, et al. “Resistance Exercise Training Offers Targeted Cognitive Benefits in Older Adults at Risk for Diabetes.” Read article here.
