Musical Activity Engagement, Depressive Symptoms, Physical Activity, and Cognitive Function in People With Type 2 Diabetes.

Background: Music interventions have beneficial effects on cognitive function and related risk factors, such as depressive symptoms and behavior of exercise participation. However, little research has been conducted on music's effects on people with type 2 diabetes, and evidence of the effect remains inconclusive in this population.

Objectives: Guided by the theory of music, mood, and movement (MMM), this exploratory study aimed to examine the direct and indirect effects of musical activity engagement, depressive symptoms, and physical activity on cognitive function in people with type 2 diabetes.

Methods: The present study is a secondary data analysis using the cross-sectional data collected from the Memory, Attention, and Problem-Solving Skills for Persons With Diabetes trial conducted between 2021 and 2023. Data were collected using self-reported questionnaires and a computerized cognitive assessment tool. A total of 189 people with type 2 diabetes and subjective cognitive decline were included in the study. Path analysis was conducted using IBM SPSS AMOS to examine the pathways of the proposed conceptual framework.

Results: The study results partially support the MMM model for subjective cognitive function but not objective cognitive function. The path model demonstrated the significant direct effects of musical activity engagement on physical activity, physical activity on subjective cognitive function, and depressive symptoms on physical activity as well as on subjective cognitive function. There was a significant indirect effect of musical activity engagement on subjective cognitive function through physical activity-which fully mediated this relationship. However, no significant direct effect of musical activity engagement on depressive symptoms and subjective cognitive function was found.

Discussion: The findings suggest that regular assessment of the presence of depressive symptoms and physical activity participation should be done in people with type 2 diabetes to identify potential modifiable factors and develop targeted interventions for cognitive health promotion. Also, our findings provide insights into the potential use of music to facilitate physical activity and manage cognitive health in people with type 2 diabetes. This study partially supports the MMM model; however, more research with a rigorous study design and larger sample size is needed to better understand the relationships among musical activity engagement, depressive symptoms, physical activity, and cognitive function.