Table 2.
Landmark randomized controlled trials looking at the benefits of clinical management of modifiable risk factors in diabetes and cognitive dysfunction
Intervention/ treatment
|
Study characteristics & benefit(s) of treatment/intervention group
|
Ref.
|
Treatment with antihypertensives acting on renin angiotensin axis | Better executive function, processing speed, verbal memory and composite score compared to those treated with other antihypertensives | Wharton et al[105], 2022 |
Intensive BP and lipid control compared to standard treatment (ACCORD trial) | Intense BP control and lipid reduction had no effects on cognitive decline. Moreover, total brain volume was found to be less with intense BP control (systolic BP < 120 mm Hg) than standard treatment after 40 mo | Williamson et al[107], 2014 |
Liraglutide therapy for T2DM | Activation of different cerebral areas with improved memory, attention, and better scores in all cognitive function tests | Li et al[112], 2021 |
Intense vs standard BP control (SPRINT trial) | Intense BP control was not associated with improvements in memory or processing speed compared to standard BP reduction | Rapp et al[113], 2020 |
10 yr of ILI vs standard care (Look AHEAD trial) | ILI resulted in better odds for emergence of: Decision-making inability (OR = 0.851) and problem solving inability (OR = 0.694) in those without these baseline complaints | Espeland et al[114], 2018 |
Finnish diabetes prevention study | Middle-aged overweight participants with impaired glucose tolerance showed better cognitive performance with low total fat & saturated fat intake, and frequent physical activities compared to standard lifestyle | Lehtisalo et al[115], 2016 |
BP: Blood pressure; T2DM: Type 2 diabetes mellitus; ILI: Intense lifestyle intervention; OR: Odds ratio.