A preliminary study to be presented at the American Heart Association's Scientific Sessions 2025 reveals that optimal cardiovascular health may offset the risk of developing mild cognitive impairment and dementia for people with Type 2 diabetes, including those with high genetic risk for cognitive decline. This research holds significant implications for the approximately 38 million Americans with diabetes, as it demonstrates that modifiable lifestyle factors can potentially counteract both genetic predisposition and diabetes-related cognitive risks.
Researchers 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 13 years. The study used the American Heart Association's Life's Essential 8 metrics to evaluate cardiovascular health, which includes eight essential components: healthy eating, physical activity, smoking cessation, healthy sleep, weight management, cholesterol control, blood sugar management, and blood pressure control.
The findings showed that 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 both mild cognitive impairment and dementia compared to those with low cardiovascular health. More strikingly, among participants with high genetic risk scores, 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 their counterparts with low cardiovascular health.
According to study corresponding author Yilin Yoshida, Ph.D., M.P.H., FAHA, an assistant professor of medicine at Tulane University School of Medicine, "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 research also found that better cardiovascular health scores were positively associated with maintained brain volume, which is significant since brain volume loss is a feature of cognitive decline and dementia.
Study first author Xiu Wu, Ph.D., emphasized that "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." This finding is particularly important given that Type 2 diabetes is associated with worse cognitive functioning and faster cognitive decline, according to the American Heart Association's 2025 Heart Disease and Stroke Statistics Update.
An additional analysis of 20,160 dementia-free adults from the National Institutes of Health's All of Us Research Hub showed similar trends, reinforcing the findings in a representative U.S. population. 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 study's implications extend beyond simply living longer to maintaining cognitive function and capacity for longer independence and better quality of life. As Yoshida explained, "In the past, we focused on the message: live healthy, live long. However, it's not just living long, it's living long and maintaining our cognitive function and capacity for longer independence and better quality of life." The research provides actionable guidance for the millions of people with Type 2 diabetes who may be concerned about their cognitive health, demonstrating that following established cardiovascular health guidelines can offer substantial protection against dementia risk.
