effect of exercise timing on inflammation and cognition in aged women with type 2 diabetes mellitus: a randomized controlled trial

Background: this study aimed to elucidate the impact of exercise timing on inflammatory markers and cognitive function in elderly women with type 2 diabetes mellitus (t2dm), with a particular focus on the expression of proteins implicated in alzheimer’s disease (ad) pathogenesis, including tyro protein tyrosine kinase-binding protein (tyrobp), soluble triggering receptor expressed on myeloid cells 2 (strem2), transforming growth factor beta (tgf-β), apolipoprotein e (apoe), and osteopontin (spp1). objectives: this research aimed to address: which exercise time — morning or evening — provides greater health benefits for elderly women with t2dm, particularly regarding key health indicators? methods: this study was a randomized controlled trial. a total of 45 women, aged 55 - 65 years, diagnosed with t2dm, were randomly assigned to morning exercise, evening exercise, or control groups using a computer-generated random number sequence. the tool used in this study is the montreal cognitive function questionnaire. the intervention consisted of a 12-week aerobic exercise (tpmp) regimen, calibrated to 60 - 70% of the participants’ maximum heart rate reserve. protein expression levels were quantified pre- and post-intervention using enzyme-linked immunosorbent assay (elisa). to mitigate bias, outcome assessors were blinded to participant group allocation via a data coding protocol. results: the results of mancova and ancova showed that aerobic activities in the morning and evening have a significant effect on cognitive performance in older adults (f = 14.17, p < 0.05); and the effects of exercise training in the evening hours are greater. also, morning exercise was associated with a statistically significant reduction in tgf-β and spp1 levels (p < 0.05), whereas evening exercise significantly decreased tyrobp and strem2 levels (p < 0.01). notably, apoe levels were markedly elevated in the evening exercise group, with a significant increase compared to the control group (p < 0.05) and the morning exercise group (p < 0.01). conclusions: the findings suggest that a structured tpmp program, regardless of timing, can beneficially modulate key inflammatory markers associated with ad in women with t2dm. these results highlight the potential for exercise as a non-pharmacological intervention to mitigate ad risk in this vulnerable population.