Cardiovascular Health May Offset Dementia Risk in Type 2 Diabetes Patients, Study Finds

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 for 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 over 13 years.

According to the American Heart Association's 2025 Heart Disease and Stroke Statistics Update, Type 2 diabetes correlates with poorer cognitive functioning and accelerated cognitive 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, researchers documented 840 participants developing mild cognitive impairment and 1,013 developing 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. This protective effect was more substantial among participants with high genetic risk scores, where those with moderate or high cardiovascular health showed 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 contribute to increased cognitive decline risk. Yoshida stated that controlling obesity, blood pressure, and insulin resistance—factors common in Type 2 diabetes—benefits cardiovascular health. The study demonstrates that following steps to enhance cardiovascular health can also reduce cognitive impairment risk among people with Type 2 diabetes.

The researchers also discovered that better cardiovascular health scores positively and significantly correlated with brain volume, suggesting individuals with higher Life's Essential 8 scores were more likely to maintain brain volume. While brain volume loss occurs naturally 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 that genes are not destiny. Maintaining optimal cardiovascular health can protect brain health even for Type 2 diabetes patients carrying the highest genetic dementia risk. This implies individuals with family histories of Alzheimer's or cognitive impairment can implement modifiable lifestyle changes that may offer protection.

Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association's Stroke Council Brain Health Committee, noted previous research showing Life's Essential 8 benefits for reducing cognitive impairment in other populations. Aparicio, who was not involved in the study, remarked that it exemplifies how what benefits the heart also benefits the brain, even when genetic factors are unfavorable. The researchers acknowledged limitations, including the study's observational nature preventing cause-and-effect establishment, and that most people do not undergo genetic testing for dementia risk.