To systematically evaluate the effects of lifestyle interventions on cognitive function in patients with type 2 diabetes mellitus (T2DM). A search of PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, and Wangfang was conducted for randomized controlled trials (RCTs) published between the establishment of the database and April 2025. Fixed-effects or random-effects models were employed for meta-analysis, with subgroup analysis by measurement tool, intervention type, duration, and cognitive status. Meta-analysis, sensitivity analysis, and publication bias assessments were performed by Stata 15.0. Twenty-seven eligible studies with a total of 2314 T2DM patients were included. A meta-analysis revealed that the combined effect size of lifestyle interventions on global cognitive function improvement was significant (SMD = 1.66, 95% CI: 1.07 to 2.25, P < 0.001). The following four factors had significant effects on the global cognitive function: country (China SMD = 2.16, 95% CI: 1.44 to 2.88, P < 0.001, Iran SMD = 1.10, 95% CI: 0.07 to 2.12, P = 0.036, Japan SMD = 0.80, 95% CI: 0.15 to 1.46, P = 0.017), intervention type (exercise SMD = 1.52, 95% CI: 0.90 to 2.14, P < 0.001, diet SMD = 4.27, 95% CI: 1.74 to 6.80, P = 0.001, comprehensive lifestyle SMD = 0.77, 95% CI: 0.05 to 1.48, P = 0.037), intervention duration (< 12 months SMD = 2.19, 95% CI: 1.50 to 2.87, P < 0.001), and cognitive status (patients with mild cognitive impairment SMD = 1.81, 95% CI: 1.20 to 2.43, P < 0.001, patients with no mild cognitive impairment SMD = 1.45, 95% CI: 0.41 to 2.49, P = 0.006). Lifestyle interventions may improve the global cognitive function of patients with T2DM. Studies with larger sample sizes and higher quality are expected to yield robust and definitive conclusions.
Wang et al. (Fri,) studied this question.
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