A study to be presented at the American Heart Association's Scientific Sessions 2025 indicates that optimal cardiovascular health may counteract the risk of developing mild cognitive impairment and dementia in individuals with Type 2 diabetes, including those with high genetic risk for cognitive decline. The research analyzed health and genetic data from the UK Biobank for over 40,000 dementia-free adults with Type 2 diabetes, evaluating the combined effects of cardiovascular health and genetic dementia risk across 13 years. According to the American Heart Association's 2025 Heart Disease and Stroke Statistics Update, Type 2 diabetes correlates with poorer cognitive function and accelerated decline. This investigation specifically assessed the joint impact of cardiovascular health, measured by the Heart Association's Life's Essential 8 metrics, and high genetic dementia risk on cognitive outcomes in adults with Type 2 diabetes.
Life's Essential 8 comprises eight components for ideal heart and brain health: improved diet, increased physical activity, tobacco cessation, healthy sleep, weight management, cholesterol control, blood sugar management, and blood pressure management. During the 13-year follow-up, 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 exhibited a 15% lower risk of both mild cognitive impairment and dementia compared to those with low cardiovascular health. The protective effect was more substantial among participants with high genetic risk scores, where those with moderate or high cardiovascular health had a 27% lower risk of mild cognitive impairment and a 23% lower dementia risk compared to their low cardiovascular health counterparts.
Study corresponding author Yilin Yoshida, Ph.D., M.P.H., FAHA, an assistant professor at Tulane University School of Medicine, explained that multiple Type 2 diabetes-related factors elevate cognitive decline and dementia risk. Yoshida stated, "People with Type 2 diabetes tend to have more obesity, higher blood pressure and insulin resistance. Controlling all those factors is also good for improving cardiovascular health. Our study found that following steps to improve cardiovascular health can also reduce the risk for cognitive impairment among people with Type 2 diabetes." The researchers also discovered that better cardiovascular health scores were positively and significantly linked to brain volume, suggesting individuals with higher Life's Essential 8 scores were more likely to maintain brain volume. While brain volume loss naturally occurs with aging, it also characterizes cognitive decline and dementia. An analysis of U.S. adults from the National Institutes of Health's All of Us Research Hub revealed similar trends, reinforcing the findings.
Study first author Xiu Wu, Ph.D., a postdoctoral fellow in the Yilin Yoshida Lab at Tulane University School of Medicine, emphasized, "Genes are not destiny. Maintaining optimal cardiovascular health can protect brain health even for people with Type 2 diabetes who carry the highest genetic risk for dementia. That means, if you have a family history of Alzheimer's or cognitive impairment, you can make the modifiable lifestyle changes that may help protect yourself." Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association's Stroke Council Brain Health Committee, noted that prior research has demonstrated benefits of adhering to Life's Essential 8 to reduce cognitive impairment in other populations. Aparicio, who was not involved in the study, remarked, "It's another great example of what's good for the heart is good for the brain, even when your genes may be stacked against you." The researchers acknowledged limitations, including the study's observational nature, which prevents establishing causation, and that most people do not undergo genetic testing for dementia risk.
