Type 2 Diabetes Mellitus (T2DM) is associated with cognitive decline in older adults due to metabolic, neuroinflammatory, and vascular alterations. These changes contribute to functional impairment, increasing the risk of falls and dependence on daily activities. Effective interventions are necessary to mitigate these effects and promote healthy aging. Physical exercise, particularly resistance training, and dual-task cognitive stimulation have been proposed as promising strategies to enhance cognitive function and functional independence in this population.

This study aimed to analyze the effects of physical exercise and dual-task cognitive stimulation on cognitive decline in individuals with T2DM through an integrative review of the literature.

An integrative review was conducted by searching PubMed, SciELO, LILACS, Web of Science, and Scopus databases. Original studies, systematic reviews, and meta-analyses published between 2005 and 2025 were included. The selected studies investigated interventions involving physical exercise and dual-task cognitive stimulation targeting cognitive decline in individuals with T2DM. Studies were analyzed regarding methodological characteristics, interventions, and cognitive outcomes.

The findings indicate that insulin resistance, neuroinflammation, and vascular dysfunction contribute to cognitive decline in individuals with T2DM. Physical exercise, especially resistance training, and dual-task interventions have demonstrated benefits in neural plasticity, cerebral metabolism, and cognitive function. Improvements were observed in executive functions, memory, attention, balance, and motor coordination, which are crucial for functional independence and fall prevention. However, the methodological heterogeneity across studies and the limited number of longitudinal clinical trials highlight the need for further research.

Evidence suggests that physical exercise and dual-task cognitive stimulation are effective in mitigating cognitive decline in older adults with T2DM. These interventions contribute to glycemic control, reduce neuroinflammation, and improve cognitive and motor functions. Future studies should focus on high-quality, longitudinal clinical trials to establish standardized protocols and confirm long-term benefits.

The incorporation of resistance training and dual-task cognitive stimulation into rehabilitation programs for individuals with T2DM may enhance cognitive and functional outcomes, promoting independence and reducing the risk of falls. Further research is needed to strengthen evidence-based practice in this field.