Olfactory training improves cognition and modifies brain networks in type 2 diabetes patients with mild cognitive impairment: A 16‐week randomised controlled trial
Bibliographic record
Abstract
AIMS: Type 2 diabetes (T2D) related cognitive impairment links to comorbid and modifiable olfactory dysfunction; however, the efficacy of olfactory training (OT) to mitigate cognitive decline specifically in these patients with mild cognitive impairment (MCI) remains unestablished. This study aimed to determine whether OT alleviates cognitive decline in this population. MATERIALS AND METHODS: In this 16-week, open-label trial, 60 T2D participants with MCI were randomly assigned (1:1) to OT or routine care (control). The OT group performed twice-daily 6-minute exposure to six odorants (rose, eucalyptus, lemon, clove, coffee, and cinnamon), with adherence monitored remotely. The primary outcome was the change in Montreal Cognitive Assessment (MoCA) score. Secondary outcomes included: (1) other neuropsychological assessments, (2) olfactory tests, (3) structural and odour-induced functional magnetic resonance imaging, and (4) metabolic parameters. RESULTS: _p = 0.190, 95% CI [0.04, 0.35]) compared to controls. Domain-specific enhancements were observed in visuospatial constructional, language, and executive function. Concurrently, OT elevated overall olfactory performance. Neuroimaging revealed parallel neural alterations, with volume increases in hippocampal subfields and prefrontal hypoactivation during tasks. Critically, mediation analysis showed olfactory enhancement (Δolfactory total score) mediated global cognitive improvement (ΔMoCA). No significant metabolic differences emerged between groups. CONCLUSIONS: A 16-week OT regimen improves global and domain-specific cognition for MCI in T2D, alongside olfactory and neuroimaging enhancements. These findings support OT as a low-cost, home-based strategy for cognitive preservation in this high-risk population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".