AIMS Midlife Type II Diabetes Mellitus (T2DM) is an important yet often unrecognised risk factor for the later development of dementia. We conducted a systematic review to assess the efficacy of non-pharmacological interventions (namely diet, exercise and cognitive training) for T2DM on cognition. METHODS A search strategy was constructed and applied to four databases: EMBASE, Medline, CINAHL and Web of Science. Peer-reviewed journal articles in English were considered assessing the effect of exercise, dietary or cognitive training/stimulation-based interventions (or any combination of these) in patients with T2DM on cognition. Results were dual-screened and extracted by two independent reviewers. RESULTS Of 4820 results, 3782 remained after de-duplication. Forty full-texts were screened and two studies were included in the final review. The first assessed the impact of a 10-year Intensive Lifestyle Intervention (ILI) on T2DM-related complications (Look-AHEAD study) and the second was a post-hoc analysis of T2DM patients from a trial of a physical activity intervention in older non-demented adult with functional limitations (LIFE Study). Whilst the Look-AHEAD study found no impact on diagnosis of MCI or dementia, the LIFE study demonstrated beneficial effects on global cognitive function and delayed memory specifically in older adults with T2DM. CONCLUSIONS There is insufficient evidence to fully assess the effect of non-pharmacological interventions on cognition in T2DM. Well-constructed trials must be designed to specifically assess the effect of non-pharmacological and multi-domain interventions for cognition in patients with T2DM in midlife. All trials examining interventions in T2DM should consider cognition as at least a secondary outcome.

中文翻译：

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非药理学干预对2型糖尿病患者的认知：系统评价。

AIMS中型II型糖尿病（T2DM）是痴呆症以后发展的重要但通常未被认识的危险因素。我们进行了系统的评估，以评估非药物干预（即饮食，运动和认知训练）对T2DM认知的疗效。方法构建搜索策略并将其应用于四个数据库：EMBASE，Medline，CINAHL和Web of Science。同行评议的英文期刊文章被认为可以评估运动，饮食或基于认知训练/刺激的干预措施（或这些措施的任意组合）对T2DM患者认知的影响。对结果进行了双重筛选，并由两名独立的审阅者进行了提取。结果在4820个结果中，重复数据删除后仍有3782个结果。筛选了40篇全文，最后的审查中包括两项研究。第一个评估了为期10年的强化生活方式干预（ILI）对T2DM相关并发症的影响（Look-AHEAD研究），第二个评估是对较老的非糖尿病患者进行体育锻炼干预后对T2DM患者的事后分析。功能障碍的痴呆成人（LIFE研究）。尽管Look-AHEAD研究未发现对MCI或痴呆症的诊断有任何影响，但LIFE研究证明对总体认知功能和延迟记忆特别是在患有T2DM的老年人中具有有益作用。结论没有足够的证据来全面评估非药物干预对T2DM认知的影响。必须设计结构合理的试验，以具体评估中年T2DM患者认知的非药物和多领域干预措施的效果。