We investigated the association between interval changes in physical activity (PA) and dementia risk among patients with new-onset type 2 diabetes.


We identified 133,751 participants newly diagnosed with type 2 diabetes in a health screening (2009–2012), with a follow-up health screening within 2 years (2010–2015). PA level changes were categorized into continuous lack of PA, decreaser, increaser, and continuous PA groups. Dementia was determined using dementia diagnosis codes and antidementia drug prescriptions.


During the median follow-up of 4.8 years, 3,240 new cases of all-cause dementia developed. Regular PA was associated with lower risks of all-cause dementia (adjusted hazard ratio [aHR] 0.82; 95% CI 0.75–0.90), Alzheimer disease (AD) (aHR 0.85; 95% CI 0.77–0.95), and vascular dementia (VaD) (aHR 0.78; 95% CI 0.61–0.99). Increasers who started to engage in regular PA had a lower risk of all-cause dementia (aHR 0.86; 95% CI 0.77–0.96). Moreover, the risk was further reduced among those with continuous regular PA: all-cause dementia (aHR 0.73; 95% CI 0.62–0.85), AD (aHR 0.74; 95% CI 0.62–0.88), and VaD (aHR 0.62; 95% CI 0.40–0.94). Consistent results were noted in various subgroup analyses.


Regular PA was independently associated with lower risks of all-cause dementia, AD, and VaD among individuals with new-onset type 2 diabetes. Those with continuous regular PA and, to a lesser extent, those who started to engage in regular PA had a lower risk of dementia. Regular PA should be encouraged to prevent dementia in high-risk populations and those with new-onset type 2 diabetes.

This article contains supplementary material online at https://doi.org/10.2337/figshare.19119233.

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