Optimal Cardiovascular Health May Reduce Dementia Risk in Type 2 Diabetes Patients

Having optimal cardiovascular health may offset the risk of developing mild cognitive impairment and dementia for people with Type 2 diabetes, even among those with a high genetic risk for cognitive decline, according to a preliminary study to be presented at the American Heart Association's Scientific Sessions 2025. The research examined the combined impact of cardiovascular health, based on the American Heart Association's Life's Essential 8 metrics, and genetic risk for dementia on cognitive outcomes in adults with Type 2 diabetes over a 13-year period.

Researchers analyzed health and genetic data from the UK Biobank for more than 40,000 dementia-free adults with Type 2 diabetes. The study assessed cardiovascular health using the American Heart Association's Life's Essential 8 score, which includes eight essential components for ideal heart and brain health: healthy eating, physical activity, smoking cessation, healthy sleep, weight management, cholesterol control, blood sugar management, and blood pressure management. Cardiovascular health was classified as high (80-100 score), moderate (50-79 score), and low (0-49 score).

The findings revealed significant protective effects of cardiovascular health on cognitive function. During the 13-year follow-up period, 840 participants developed mild cognitive impairment and 1,013 developed dementia. After adjusting for age, sex and race, participants with moderate or high cardiovascular health had a 15% lower risk of developing mild cognitive impairment and a 15% lower risk of developing dementia compared to those with low cardiovascular health. The protective effect was even more pronounced among participants with high genetic risk scores, where those with moderate or high cardiovascular health had a 27% lower risk of developing mild cognitive impairment and a 23% lower risk of developing dementia compared to those with low cardiovascular health.

Better cardiovascular health scores were also positively and significantly associated with brain volume, indicating that people with higher Life's Essential 8 scores were more likely to have maintained brain volume. While brain volume loss is a natural part of aging, it is also a feature of cognitive decline and dementia. An analysis of U.S. adults from the National Institutes of Health's All of Us Research Hub showed similar trends, with 667 adults developing mild cognitive impairment and 538 developing dementia during a 15-year follow-up period.

Study corresponding author Yilin Yoshida, Ph.D., M.P.H., FAHA, emphasized that genes are not destiny when it comes to cognitive health. Maintaining optimal cardiovascular health can protect brain health even for people with Type 2 diabetes who carry the highest genetic risk for dementia. This means individuals with a family history of Alzheimer's or cognitive impairment can make modifiable lifestyle changes that may help protect themselves. The study's findings support the concept that what's good for the heart is good for the brain, even when genetic factors may increase risk.

Researchers noted the study had limitations, including its observational nature which cannot establish cause and effect. Additionally, since most people do not undergo testing for genetic risk for dementia, they may not know if they are at risk. The study featured in this news release is a research abstract presented at the American Heart Association's scientific meetings and is not peer-reviewed, with findings considered preliminary until published as full manuscripts in a peer-reviewed scientific journal.