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

Maintaining optimal cardiovascular health may significantly reduce the risk of developing mild cognitive impairment and dementia for people with Type 2 diabetes, according to preliminary research to be presented at the American Heart Association's Scientific Sessions 2025. The study found this protective effect persists even among individuals with a high genetic predisposition to cognitive decline, offering hope for millions managing diabetes worldwide.

The research examined health and genetic data from the UK Biobank for more than 40,000 dementia-free adults with Type 2 diabetes, assessing the joint effects of cardiovascular health and genetic risk for dementia over a 13-year period. Cardiovascular health was evaluated using the American Heart Association's Life's Essential 8 metrics, which include eight essential components for ideal heart and brain health: eating better, being more active, quitting tobacco, getting healthy sleep, managing weight, controlling cholesterol, managing blood sugar, and managing blood pressure.

During the follow-up period, researchers documented 840 cases of mild cognitive impairment and 1,013 cases of dementia among participants. After adjusting for age, sex and race, the analysis revealed that participants with moderate or high cardiovascular health had a 15% lower risk of developing both mild cognitive impairment and 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 showed a 27% lower risk of developing mild cognitive impairment and a 23% lower risk of developing dementia.

"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," said study first author Xiu Wu, Ph.D., a postdoctoral fellow of medicine in the Yilin Yoshida Lab at Tulane University School of Medicine. "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."

The study also found that better cardiovascular health scores were 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 some brain volume loss occurs naturally with aging, accelerated loss is a characteristic feature of cognitive decline and dementia. An additional analysis of U.S. adults from the National Institutes of Health's All of Us Research Hub showed similar trends, reinforcing the findings across different populations.

According to the American Heart Association's 2025 Heart Disease and Stroke Statistics Update, Type 2 diabetes is associated with worse cognitive functioning and faster cognitive decline. Study corresponding author Yilin Yoshida, Ph.D., M.P.H., FAHA, explained that "there are multiple factors associated with Type 2 diabetes that contribute to an increased risk of cognitive decline and dementia. 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."

The findings align with previous research showing the benefits of following Life's Essential 8 to reduce cognitive impairment in other populations. Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association's Stroke Council Brain Health Committee, noted that "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 research underscores the importance of comprehensive health management for individuals with Type 2 diabetes, highlighting that lifestyle interventions can potentially mitigate both cardiovascular and cognitive risks simultaneously.