Introduction Type 2 diabetes (T2D) is a risk factor for dementia. Ischemia due to vascular pathology is hypothesized to be an underlying mechanism for this association. Hyperbaric oxygen therapy (HBOT) is a treatment in which oxygen‐enriched air (up to 100%) is administered to patients in a chamber at a pressure above one atmosphere absolute. HBOT is approved for the treatment of T2D ischemic non‐healing wounds. Evidence from animal studies and small clinical trials suggests that HBOT improves hypoxic/ischemic brain injuries, consequently inducing brain angiogensis, leading to cognitive improvement. Methods We present the design of the first double‐blind, placebo‐controlled, clinical trial on brain and cognitive outcomes in elderly (n = 154) with T2D and mild cognitive impairment to compare the effects of HBOT versus sham (normal air with 1.1 ATA pressure in the first and last 5 minutes of the session). Eligible candidates are randomized with equal probability to HBOT and sham. Outcomes are assessed before and after treatment, and at 6‐ and 12‐month follow‐up. The primary cognitive outcome is global cognitive change, indexed by a composite sum of z‐scores of four executive functions and four episodic memory tests. The primary neurobiological outcome is cerebral blood flow (CBF; via arterial spin labeling magnetic resonance imaging [ASL‐MRI]) and cerebral glucose utilization via fluorodeoxyglucose positron emission tomography (FDG‐PET). Secondary outcome measures are specific cognitive domains (executive function and episodic memory) and functional measures (Clinical Dementia Rating sum of boxes, activities of daily living). Efficacy analyses will be performed for the intent‐to‐treat sample. Discussion Recent studies suggest that HBOT induces neuroplasticity and improves cognition in post‐stroke and traumatic brain injury patients. However, its effect on cognition, cerebral blood flow, and brain glucose utilization in T2D patients at high dementia risk is yet to be determined. If effective, this study may provide strong evidence for the brain and cognitive benefits of HBOT in this population.
COVID-19 led to unprecedented lockdowns and changes in older adults’ lives, especially those with type 2 diabetes who have high risk of complications and mortality. We investigated the associations of cognitive and motor function and gray matter volumes (GMVs) with COVID-19 lockdown-related emotional distress of type 2 diabetes older adults, participating in the Israel Diabetes and Cognitive Decline Study. We administered a questionnaire to obtain information about anxiety, depression, general well-being, and optimism during a mandated lockdown. Lower grip strength before lockdown was associated with increased sadness, anxiety, and less optimism. Slower gait speed was associated with greater sadness. Lower GMV was related to greater anxiety during the lockdown when compared with anxiety levels before the COVID-19 outbreak. Yet, global cognition was not associated with any emotional distress measure. These results support the role of good motor function on emotional well-being during acute stress and GMV as a potential underlying mechanism.
Background Type 2 diabetes (T2D) is associated with accelerated cognitive decline and increased dementia risk. Lockdowns imposed due to the Covid‐19 outbreak led to unprecedented changes in the life of older adults. However, little is known about emotional distress consequences. We assessed associations of grey matter (GM) volumes (N=179), cognitive and motor functions (N=403) with emotional distress of older adults with T2D from the Israel Diabetes and Cognitive Decline Study (IDCD). Methods During the first Covid‐19‐related lockdown in Israel, we applied a phone questionnaire, which included information about anxiety (“Over the last two weeks, how much have you been bothered by Feeling anxious or nervous?”; Anxiety levels now compared to before Covid‐19), depression (“Over the last two weeks, how much have you been bothered by feeling sad, down, or uninterested in life?”; sad feelings now compared to before Covid‐19), general well‐being (“How are you feeling in general?”), optimism towards the future (“Are you optimistic towards the future?”). Grey matter (GM) volumes (measured by high resolution T1‐weighted MRI), cognitive (a global measure summarizing 14 cognitive tests) and motor function (gait speed and grip strength), are routinely assessed by the IDCD study. Spearman correlation adjusting for age, sex, education, HbA1c and duration of T2D (as well as TICV for the GM analyses) examined associations of GM, cognitive and motor functions with emotional distress measures. Results The sample averaged 72 years of age (SD=4.4), and 14 years of education (SD=3.5); 40.9% were female. Lower grip strength prior to lockdown was associated with increased sadness (r=‐0.21, p<0.001) and anxiety (r=‐.011, p=0.020), less optimism (r=0.10, p=0.042) and lower general feeling (r=0.17, p=0.0005). Slower gait speed was associated with increased sadness (r=0.13, p=0.005). Lower GM was associated with greater anxiety during the lockdown (r=‐0.19, p=0.011) and compared to before Covid‐19 (r=‐0.19, p=0.012). Global cognition was not associated with any of the emotional distress measures. Conclusions Motor function, but not cognitive function, were associated with lockdown imposed emotional distress in older adults with T2D. These associations point to the importance of good motor function and physical conditioning in emotional well‐being related to acute stress related to stay‐at‐home‐orders.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.