- In 2024, about 589 million adults around the world were living with diabetes, with over 90% of those cases being type 2 diabetes.
- Previous research shows that people with type 2 diabetes are at an increased risk for several health issues, including heart diseases and dementia.
- A new study has found that people with type 2 diabetes who achieve optimal heart health by following the American Heart Association’s ‘Life’s Essential 8‘ may have a lower risk of developing mild cognitive impairment and dementia.
According to the International Diabetes Federation, in 2024 about 589 million adults around the world were living with diabetes, with over 90% of those cases being type 2 diabetes.
Previous research has shown that people with type 2 diabetes are at an increased risk for several health issues, including kidney disease, nerve damage (neuropathy), diabetic retinopathy, as well as
“People with type 2 diabetes have a markedly increased risk ([approximately] 50%) of mild cognitive impairment (MCI) and dementia, including both Alzheimer’s disease and vascular dementia, compared with individuals with normal glucose levels,” Yilin Yoshida, PhD, MPH, FAHA, diabetes epidemiologist and assistant professor of medicine at Tulane University School of Medicine in New Orleans, told Medical News Today.
“Unfortunately, there are currently no effective therapeutic strategies to meaningfully reduce this risk,” Yoshida added.
She is the lead author of a new study recently presented at the
This study is yet to appear in a peer-reviewed journal.
For this study, researchers analyzed health and genetic data of more than 15,000 adults with type 2 diabetes but without dementia from the U.K. Biobank, and of more than 20,000 adults from All of Us. Study participants were followed for more than 13 years to assess their cardiovascular health and what percentage developed MCI or dementia.
Cardiovascular health was assessed through the AHA’s Life’s Essential 8 metrics, which include:
- being more physically active
- controlling cholesterol levels
- following a healthier diet
- getting enough sleep
- keeping healthy blood sugar levels
- maintaining a healthy weight
- managing blood pressure
- not smoking.
“We chose to examine optimal cardiovascular health using the AHA’s Life’s Essential 8 metrics because they comprehensively capture key lifestyle and clinical factors — diet, physical activity, sleep, blood pressure, cholesterol, glucose, smoking, and body weight — that influence both cardiovascular and brain health, and importantly, are modifiable,” Yoshida explained.
“By assessing the relationship between Life’s Essential 8 and cognitive outcomes in individuals with type 2 diabetes, we aimed to determine whether maintaining optimal cardiovascular health could attenuate the elevated dementia risk associated with type 2 diabetes, even among those with a high genetic susceptibility to dementia, thereby providing actionable insights for prevention strategies that address multiple modifiable factors simultaneously.”
– Yilin Yoshida, PhD, MPH, FAHA
At the study’s conclusion, researchers found that study participants with moderate to high cardiovascular health decreased both their MCI and dementia risks by 15%, compared to those with low cardiovascular health.
“These findings highlight the potential of maintaining moderate or ideal cardiovascular health to protect brain health among the high-risk type 2 diabetes populations,” Yoshida said.
“This risk reduction in MCI and dementia suggests that adhering to the AHA’s Life’s Essential 8 metrics — which include healthy behaviors and well-controlled clinical factors — may slow or delay cognitive aging through better vascular function, reduced inflammation, and improved metabolic regulation,” the researcher added.
Among study participants with a high genetic risk for dementia, scientists found that those who had moderate-to-high cardiovascular Health lowered their MCI risk by 27% and dementia risk by 23%, compared to those with low heart Health.
“These results indicate that dementia risk is not predetermined, and that comprehensive management of lifestyle and cardiometabolic factors provides a modifiable and actionable pathway to preserve cognitive function in people with type 2 diabetes, even among those with high genetic susceptibility to dementia,” Yoshida explained.
The researchers also discovered that study participants with better heart Health scores were positively and significantly associated with
“This finding suggests that maintaining better cardiovascular health may help preserve brain structure in people with type 2 diabetes,” Yoshida told us. “Larger brain volume is generally considered a marker of healthier brain aging and is associated with a lower risk of cognitive decline and dementia.”
MNT had the opportunity to speak with Peter Gliebus, MD, chief of neurology and director of cognitive and behavioral neurology at Marcus Neuroscience Institute, a part of Baptist Health South Florida, about this research.
“I see many patients with type 2 diabetes who are concerned about the potential for cognitive decline in the future,” Gliebus, who was not involved in the study, commented. “This study reinforces the critical importance of maintaining good cardiovascular health, managing risk factors, and adopting healthier lifestyles.“
“It also confirms the long-held suspicion that — even when genetics are not in one’s favor — lifestyle interventions can still play a significant role in preserving cognitive function,” he noted.
“It is essential to continue researching new strategies to help individuals with type 2 diabetes reduce their risk of cognitive decline, as they are considered at higher risk for developing it over time, and the prevalence of type 2 diabetes is very high,” Gliebus advised.
“These strategies may include new medications as well as lifestyle interventions. As we see progress in the management of diabetes and other cardiovascular risk factors, there is hope that these advancements will also contribute to lowering the risk of future cognitive decline,” he told us.
MNT also spoke with Rigved Tadwalkar, MD, FACC, a consultative cardiologist and director of Digital Transformation Pacific Heart Institute in Santa Monica, CA, about this study. Tadwalkar, who was not involved in the research, commented that it was a really thoughtful piece of work.
“It confirms something we see every day in clinical practice — that the heart and brain don’t operate in isolation,” he told MNT. “What’s interesting here is that maintaining good cardiovascular health made a measurable difference among people with type 2 diabetes, even for those who carry a higher genetic risk for dementia.”
“It’s encouraging to see lifestyle factors having that much of an influence,” he added. “I find it empowering to remind patients that their daily habits actually do matter. Complicated interventions or expensive treatments are not needed, it’s about the basics like eating well, moving regularly, sleeping enough, and keeping the major risk factors in check. Those simple habits ripple outward to protect not just the heart, but also the brain.”
For people who may want to start better applying the AHA’s “Life’s Essential 8” to their lifestyle choices, Tadwalkar advised not to aim for perfection across all eight areas at once.
“Start with one or two that feel manageable and build from there,” he suggested. “Maybe it’s walking after dinner most nights, or turning screens off a little earlier to get better sleep. Small but consistent habits tend to stick better than big, sudden changes.”
“For people with type 2 diabetes, keeping blood sugar, blood pressure, and cholesterol under control is essential, but it’s all connected,” Tadwalkar added. “Less processed food and more movement make the medical aspect easier to manage as well. Importantly, progress matters more than perfection, and the benefits do add up over time.”
