Objectives: Type 2 diabetes is associated with deficits in cognition and brain health. Individuals with at least 1 risk factor for diabetes (i.e. obesity, prediabetes) already experience some neurocognitive impairment and are at risk for further decline. One way to combat these deficits is through exercise, but it is unknown whether resistance exercise can improve these functions in this at-risk group.

Methods: This study was a pilot randomized controlled trial. Participants were 60 to 80 years of age and had prediabetes (fasting capillary glucose 6.1 to 6.9 mmol/L) and/or were living with overweight or obesity (body mass index ≥25 kg/m(2)). Participants completed resistance training or balance and stretching exercises (control) thrice weekly for 6 months. Neuropsychological tests were used to assess cognitive ability, whereas functional magnetic resonance imaging was used to examine brain activation patterns.

Results: Resistance training led to improvements in task-switching, attention, and conflict resolution, as well as improved patterns of brain activation that may mimic healthy older adults.

Conclusions: Resistance exercise may serve as an effective behavioural strategy to improve neurocognition in older adults at risk for type 2 diabetes. A large-scale powered trial is needed to further explore these findings.