Optimal Cardiovascular Health May Offset Dementia Risk in Type 2 Diabetes Patients
New research suggests that maintaining optimal cardiovascular health through the American Heart Association's Life's Essential 8 metrics can significantly reduce the risk of cognitive decline and dementia in people with Type 2 diabetes, even for those with high genetic risk.
A new study indicates that maintaining optimal cardiovascular health may significantly reduce the risk of developing mild cognitive impairment and dementia for people with Type 2 diabetes, even among those with high genetic risk for cognitive decline. The preliminary research, to be presented at the American Heart Association's Scientific Sessions 2025, examined data from over 40,000 dementia-free adults with Type 2 diabetes from the UK Biobank over a 13-year period.
Researchers assessed cardiovascular health 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. The study found 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 findings were particularly striking among participants with high genetic risk for dementia. 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 compared to their counterparts with low cardiovascular health. The research also revealed that better cardiovascular health scores were positively associated with maintained brain volume, which is significant since loss of brain volume is a feature of cognitive decline and 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 at Tulane University School of Medicine. The study's corresponding author, Yilin Yoshida, Ph.D., M.P.H., FAHA, emphasized that controlling multiple factors associated with Type 2 diabetes—including obesity, blood pressure, and insulin resistance—not only improves cardiovascular health but also reduces cognitive impairment risk.
An additional analysis of 20,160 dementia-free adults from the National Institutes of Health's All of Us Research Hub showed similar trends in a representative U.S. population. The study's implications are significant 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 available at https://www.heart.org.
Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association's Stroke Council Brain Health Committee, noted that these findings reinforce the concept that "what's good for the heart is good for the brain, even when your genes may be stacked against you." The research builds on previous studies showing the benefits of following Life's Essential 8 to reduce cognitive impairment in other populations, now extending these findings to people with Type 2 diabetes who are at increased risk for Alzheimer's disease and dementia.
While the study has limitations—including its observational nature and inability to establish cause and effect—the results provide compelling evidence that modifiable lifestyle factors can significantly impact brain health outcomes. The findings suggest that healthcare providers should emphasize comprehensive cardiovascular health management as part of diabetes care to potentially mitigate cognitive decline risks.