Researchers studied 468 older adults with type 2 diabetes to understand what helps them stay mentally and physically strong as they age. They found that people taking metformin (a common diabetes medication) and those who eat well were much less likely to experience both mental slowness and physical weakness at the same time. About 1 in 10 people in the study had this combination of problems. The good news is that both metformin use and good nutrition are things doctors can help manage, which might help older adults with diabetes live better, more independent lives.

The Quick Take

  • What they studied: Whether taking metformin and eating well can help older adults with diabetes avoid becoming both mentally foggy and physically weak at the same time
  • Who participated: 468 older adults (average age 70) with type 2 diabetes visiting a hospital clinic; about 70% were women
  • Key finding: People taking metformin were about 73% less likely to have both mental and physical problems together. People with good nutrition were about 85% less likely to have these combined problems.
  • What it means for you: If you’re an older adult with diabetes, staying on your metformin prescription and eating nutritious foods may help you keep your thinking sharp and stay physically active. However, this study shows a connection, not proof that these things cause better outcomes.

The Research Details

This was a cross-sectional study, which means researchers looked at a group of people at one point in time rather than following them over months or years. They visited a geriatric (older adult) clinic at a hospital and collected information about 468 older adults with type 2 diabetes. They measured three things: whether people were taking metformin, how well-nourished they were, and whether they had problems with thinking or physical strength.

The researchers used specific tests to measure these factors. They checked thinking ability using a test called the Montreal Cognitive Assessment (MoCA), where a score of 25 or lower meant someone had thinking problems. They measured physical strength using the FRAIL score, where a score of 3 or higher meant someone was physically weak. They also measured nutrition using a screening tool called the MNA-SF.

The researchers then used statistical methods to see if metformin use and good nutrition were connected to having fewer thinking and physical problems, while accounting for other factors like age, sex, weight, education, vitamin B12 levels, kidney function, and other medications people were taking.

This research approach is important because it looks at real patients in a real clinic setting, not just in a laboratory. By measuring multiple factors at the same time, researchers can see which ones are most connected to staying mentally and physically strong. Understanding these connections helps doctors know what they can help patients control to prevent problems.

This study has some strengths: it included a reasonably large group of people (468), it measured multiple important factors, and it tried to account for other things that might affect the results. However, because it only looked at people at one point in time, we can’t be completely sure that metformin and good nutrition actually cause better outcomes—they might just be connected to them. The study was done at one hospital clinic, so the results might not apply to all older adults with diabetes everywhere.

What the Results Show

The researchers found that about 1 in 10 people (9.6%) had both thinking problems and physical weakness together. Another 1 in 10 (9.6%) had thinking problems alone, and about 2 in 10 (18.8%) had physical weakness alone. This means that many older adults with diabetes experience at least some of these problems.

When they looked at metformin use, people taking this medication were much less likely to have both thinking and physical problems together. Specifically, they had about 73% lower odds of having this combination of problems compared to people not taking metformin. The same medication also protected against thinking problems alone and physical weakness alone.

Good nutrition was even more protective. People who were well-nourished had about 85% lower odds of having both thinking and physical problems together. They also had much lower odds of having either problem separately. These protective effects stayed strong even after the researchers accounted for other factors like age, weight, kidney function, and other medications.

The study also found that metformin and good nutrition separately protected against just thinking problems or just physical weakness. This suggests that these two factors work broadly to help older adults stay healthy, not just in one specific way. The researchers also noted that vitamin B12 levels, kidney function, and other medications mattered, which is important because metformin can sometimes affect B12 levels in older adults.

Previous research has suggested that metformin might have benefits beyond just controlling blood sugar, including protecting the brain and muscles. This study supports those earlier findings in older adults specifically. The connection between good nutrition and staying mentally and physically strong is well-established in older adult research, so this finding confirms what doctors already suspected.

This study has several important limitations. First, it only looked at people at one point in time, so we can’t prove that metformin and good nutrition actually cause better outcomes—they might just be connected to them. Second, the study was done at one hospital clinic, so the results might not apply to all older adults with diabetes. Third, the study couldn’t prove why metformin and good nutrition help—the reasons aren’t completely clear. Finally, about 70% of participants were women, so the results might not apply equally to older men with diabetes.

The Bottom Line

If you’re an older adult with type 2 diabetes, talk to your doctor about staying on metformin if you’re currently taking it (moderate confidence). Focus on eating nutritious foods including adequate protein, fruits, vegetables, and whole grains (high confidence). These two factors appear to work together to help keep your mind sharp and your body strong. However, these recommendations should be personalized by your doctor based on your specific health situation.

This research is most relevant to older adults (65+) with type 2 diabetes who want to stay mentally sharp and physically active. It’s also important for family members and caregivers of older adults with diabetes. Doctors caring for older adults with diabetes should consider this information when discussing treatment options. This research is less directly relevant to younger people with diabetes or people without diabetes.

The benefits of good nutrition can start appearing within weeks to months, though the full effects may take several months. Metformin’s protective effects likely develop over months to years of consistent use. You shouldn’t expect overnight changes, but staying consistent with both medication and nutrition should help over time.

Want to Apply This Research?

  • Track weekly nutrition scores using a simple 1-10 scale based on how many days you ate balanced meals with protein, vegetables, and whole grains. Also log whether you took your metformin as prescribed each day.
  • Set a daily reminder to take metformin at the same time each day. Plan one nutritious meal per day that includes protein, vegetables, and whole grains. Use the app to log these meals and get feedback on your nutrition patterns.
  • Monthly, review your metformin adherence percentage and your average weekly nutrition score. Every 3 months, note any changes in how sharp your thinking feels or how strong you feel physically. Share these trends with your doctor at regular appointments.

This research shows a connection between metformin use, good nutrition, and better mental and physical health in older adults with diabetes, but it does not prove cause and effect. This information is for educational purposes only and should not replace advice from your doctor. Always talk to your healthcare provider before making changes to your diabetes medications or diet, especially if you have kidney problems or vitamin B12 deficiency. Individual results may vary based on your specific health situation.