December 14, 2022
About one in 10 Americans has diabetes, a disorder of blood sugar control that can lead to heart attacks, strokes, kidney failure, blindness and other life-threatening problems. Diabetes can also take a toll on the brain, increasing the risk of dementia. But adopting seven healthy lifestyle measures, including getting a good night’s sleep, exercising regularly and having frequent social interactions, can greatly reduce the risk of dementia in people with diabetes, a new study found.
“For people with type 2 diabetes,” the most common form of diabetes, “the risk of dementia may be greatly reduced by living a healthier lifestyle,” said study author Dr. Yingli Lu, of Shanghai Jiao Tong University School of Medicine in China. “Doctors and other medical professionals who treat people with diabetes should consider recommending lifestyle changes to their patients. Such changes may not only improve overall health, but also contribute to prevention or delayed onset of dementia in people with diabetes.” The findings were published in the journal Neurology.
For this very large study, researchers looked at 167,946 people 60 and older who were part of a large health care database in the United Kingdom. None had Alzheimer’s disease or other forms of dementia at the start of the study. Participants completed detailed health questionnaires and underwent medical checkups and blood tests.
Participants were ranked according to how closely they adhered to seven lifestyle habits known to promote brain health. They included:
- Getting regular physical exercise (at least two-and-a-half hours of moderate exercise or an hour and fifteen minutes of vigorous exercise a week)
- Avoiding sedentary behaviors (watching TV less than four hours a day)
- Getting seven to nine hours of sleep a night
- Eating a heart-healthy diet rich in fruits, vegetables, whole grains and fish and low in processed foods and meats
- Having frequent social contacts, including gathering with friends and family or engaging in social activities at least once a week
- Drinking in moderation (no more than one drink a day for women or two a day for men)
- Not smoking
The researchers found that 4 percent of the people complied with one or two, or none, of the healthy habits, while 11 percent followed three; 22 percent followed four; 30 percent followed five; 24 percent followed six; and 9 percent complied with all seven. Over the next 12 years, a total of 4,351 of those in the study group (167,946 people) developed Alzheimer’s disease or other forms of dementia.
After adjusting for factors like age, education and ethnicity, the researchers found that people who followed all the healthy/recommended habits had a 54 percent lower risk of dementia than those who followed two or fewer. Each additional healthy habit that someone followed was associated with an 11 percent decreased risk of dementia. As earlier studies have shown, having diabetes increased the risk of developing dementia, even if you followed all seven healthy habits, but the more habits you followed, the lower your risk.
The findings are consistent with earlier research showing links between diabetes and dementia, and how lifestyle habits can have a major impact on the risk of developing dementia.
Diabetes is known to be associated with damaged blood vessels throughout the body, including in the brain, and diabetes is already a well known risk factor for dementia. One earlier study found that patients with untreated diabetes developed signs of Alzheimer’s disease 1.6 times faster than people who did not have diabetes. People with Type 2 diabetes should be treated promptly and consistently for their disease, which will not only help to manage their diabetes but may also help keep Alzheimer’s disease and other forms of dementia at bay.
Scientists have also found links between insulin, a crucial hormone that helps the body maintain healthy levels of blood sugar and that is used as a treatment for diabetes, and the memory problems of Alzheimer’s. Preliminary studies even suggest that delivering squirts of aerosolized insulin deep into the nose, where it can easily access the brain, may improve memory and thinking skills in those with Alzheimer’s disease.
Better understanding of the link between diabetes and Alzheimer’s could lead to better treatments for the devastating disease, though more studies are needed before doctors should begin prescribing diabetes drugs for Alzheimer’s. Preventing diabetes in the first place may be one way to help maintain long-term brain health. Keeping weight down, getting regular exercise and eating a Mediterranean-style diet rich in fresh fruits and vegetables may all help to keep diabetes at bay – and in the process may help to stem the memory loss of Alzheimer’s.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Bin Wang, Ying Sun, Xiao Tan, Jihui Zhang, Ningjian Wang, Yingli Lu: “Association of Combined Healthy Lifestyle Factors With Incident Dementia in Patients With Type 2 Diabetes.” Neurology, September 14, 2022