Effects Of Metformin Combined With Aerobic Exercise On Cognitive Function In Elderly Patients With Type 2 Diabetes

Objective:With the aging of the population,the incidence of diabetes and dementia has increased year by year,and has become an important public health problem.The cognitive impairment caused by diabetes has also gradually gained attention.Studies have confirmed that metformin and aerobic exercise can protect cognitive function in elderly type 2 diabetic patients.Based on this,this study intends to combine metformin with aerobic exercise to explore the effects of metformin and aerobic exercise on cognitive function in elderly patients with type 2 diabetes with mild cognitive impairment.Methods:This experiment was conducted from November 2017 to May 2018,and the elderly patients with type 2 diabetes who were treated in the Department of Geriatrics of the First Hospital of Shanxi Medical University and the Gaoxin Community Health Service Station of Taiyuan City were screened one by one.Inclusion criteria:(1)age ? 60 years;(2)meet the WHO Diabetes Diagnostic Criteria(1999);(3)meet the diagnostic criteria for mild cognitive impairment in the Chinese Diabetes and Cognitive Disorder Guidelines(2015 Edition): 1 patient or insider report,or experienced clinician finds cognitive impairment;2 objective evidence of one or more cognitive domain impairments(from cognitive tests);3 complex instrumental daily abilities can be slightly Damage,but maintain independent ability to daily life;4 has not yet reached the diagnosis of dementia.This study was divided into the study group's hypoglycemic regimen and exercise habits,which were divided into the combined intervention group,metformin group and control group.(1)Combined intervention group: regular oral metformin 500 mg 3 times / day,while aerobic exercise.Aerobics follows the 2017 edition of the China Guidelines for Type 2 Diabetes Prevention and the American Diabetes Association's 2017 Standards of Medical Care in Diabetes: Each subject completes at least 5 times a week,30 minutes of moderate intensity Aerobic exercise,exercise a little hard,breathing heartbeat is fast but not rush,sports can choose fast walking,tai chi,square dance and other means.(2)metformin group: regular oral metformin 500 mg 3 times / day;(3)control group: can continue to use other hypoglycemic agents other than metformin,or no drugs,metformin group and control group do not participate in any aerobic exercise program.Researchers or community service station staff will have an interview or telephone contact every 2 weeks to urge patients to take regular metformin and regular aerobic exercise.If the patient is unable to adhere to aerobic exercise,or if there are unexpected complications such as acute complications of diabetes,cerebrovascular disease,or fracture,the experiment should be excluded at any time.Before the intervention and 6 months after the intervention,all enrolled subjects completed the Concise Mental State Scale,the Montreal Cognitive Assessment Scale,and the Daily Living Ability Scale to assess the cognitive function of the three groups.Results:In this study,80 elderly patients with type 2 diabetes mellitus with mild cognitive impairment were enrolled,including a combined intervention group(29 patients),metformin group(21 patients),and a control group(30 patients).After the intervention,the scores of the Concise Mental State Scale of the combined intervention group and metformin group were 27.82±1.63 and 25.71±2.76,respectively,which were higher than those before the intervention,and the score of the combined intervention group was higher than that of the metformin group.The difference was statistically significant(P< 0.05).The Montreal Cognitive Assessment Scale scores of the combined intervention group and the metformin group were 23.37±2.99 and 20.05±4.14,respectively,which were higher than those before the intervention.The combined intervention group had higher scores than the metformin group,and the difference was statistically significant(P<0.05).After the intervention,the visual spatial abilities in the Montreal Interventional Assessment Scale and the metformin group were 1.21±0.49,1.00±0.55,respectively,which was higher than before the intervention,and the combined intervention group score was higher than the metformin group;The intervention ability of the intervention group and the metformin group were 2.35±0.77 and 1.95±0.80,respectively,which was higher than that before the intervention,and the score of the combined intervention group was higher than that of the metformin group.The abstract ability of the combined intervention group and the metformin group was 1.17±0.71,0.90,respectively.±0.77,higher than before intervention,and the combined intervention score was higher than metformin group;the delayed recall ability of the combined intervention group and metformin group were 3.07±1.16,2.15±1.03,respectively,higher than before intervention,and the joint intervention group scored high.In the metformin group,the difference was statistically significant(P<0.05).After the intervention,the naming abilities of the combined intervention group and the metformin group were 2.55±0.57 and 2.43±0.68,respectively,which were higher than those before the intervention,and the combined intervention group score was higher than the metformin group;the combined intervention group and the metformin group had a language ability of 1.90.±0.67,1.86±0.73,higher than before intervention,and the combined intervention score was higher than metformin group,the difference was not statistically significant(P>0.05).The attention ability of the combined intervention group and the metformin group were 5.24±0.99 and 4.29±1.31,respectively.The attention ability of the combined intervention group was higher than that before the intervention,and the metformin group was decreased.The combined ability of the combined intervention group and metformin group was 5.79±0.49,respectively.5.19±0.81,the orientation ability of the combined intervention group was higher than that before the intervention,and the metformin group was flat.In summary,it can be seen that:(1)After the intervention,the concise mental state scale and the Montreal Cognitive Assessment Scale scores of the patients in the combined intervention group and the metformin group were higher than those before the intervention,and the combined intervention group score was higher than that of the metformin group.The difference was statistically significant(P<0.05).(2)After intervention,the visual spatial ability,executive ability,abstract ability and delayed recall ability of the joint intervention group and the metformin group in the Montreal Cognitive Assessment Scale sub-project were higher than those before the intervention,and the combined intervention group increased significantly.The difference was statistically significant(P<0.05).(3)After intervention,the naming ability and language ability of the Montreal Interventional Assessment Scale and the metformin group were higher than those before the intervention,and the combined intervention group was higher than the metformin group,and the difference was not statistically significant(P> 0.05).(4)The attention ability of the combined intervention group was higher than that before the intervention,but decreased in the metformin group.After the intervention,the orientation ability of the combined intervention group was higher than that before the intervention,and the metformin group was the same.Conclusion:After the intervention,the Mini-Mental State Scale score of the combined intervention group and the metformin group,the total score of the Montreal Cognitive Assessment Scale,and the visual spatial ability,execution ability,naming,language,abstraction,delayed recall,and daily living ability in each subproject The score of the scale was higher than that before the intervention,and the combination of the intervention group was more obvious,indicating that metformin combined with aerobic exercise can effectively protect the cognitive function of elderly patients with type 2 diabetes with mild cognitive impairment and improve the quality of life of patients.