Moderate-to-Vigorous Physical Activity and Cerebral Small Vessel Disease in Older Adults with Type 2 Diabetes: A Cross-sectional Study.

Abstract

Cerebral small vessel disease (SVD) is prevalent in older adults with type 2 diabetes and contributes to an elevated risk of cognitive decline. Although physical activity (PA) is a potentially modifiable factor in SVD prevention, previous findings remain inconsistent, particularly regarding activity intensity. This study aimed to investigate the association between accelerometer-measured PA and SVD severity in older adults with type 2 diabetes. This cross-sectional study analyzed 66 adults aged ≥70 years with type 2 diabetes. PA was objectively measured using a triaxial accelerometer over 14 days. Time spent in sedentary behavior (≤1.5 metabolic equivalents [METs]), light-intensity PA (LPA; 1.6-2.9 METs), and moderate-to-vigorous PA (MVPA; ≥3.0 METs) were assessed. Lacunes, cerebral microbleeds, enlarged perivascular spaces, and white matter hyperintensities were evaluated using brain magnetic resonance imaging. The total SVD score (range, 0-4) was calculated, and participants were categorized into either mild (score 0-1) or moderate-to-severe (score 2-4) groups. To estimate the odds of having moderate-to-severe SVD associated with a hypothetical reallocation of 10 min of sedentary time to either LPA or MVPA, multiple logistic regression analysis using an isotemporal substitution model was performed. Of the 66 participants, 29 (43.9%) had moderate-to-severe SVD. A hypothetical reallocation of 10 min from sedentary time to MVPA was associated with lower odds of moderate-to-severe SVD (odds ratio, 0.78; 95% confidence interval, 0.61-1.00; P = 0.047). LPA exhibited no significant association. Engaging in MVPA is associated with lower SVD severity in older adults with type 2 diabetes.