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Diabetes in Midlife Linked to Significant Cognitive Decline 20 Years Later

People diagnosed with diabetes in midlife are more likely to experience significant memory and cognitive problems during the next 20 years than those with healthy blood sugar levels, new Johns Hopkins Bloomberg School of Public Health (JHSPH) research suggests.

The researchers found that diabetes appears to age the mind roughly five years faster beyond the normal effects of aging. For example, on average, a 60-year-old with diabetes experiences cognitive decline on par with a healthy 65-year-old aging normally. Decline in memory, word recall, and executive function is strongly associated with progression to dementia, a loss of mental capacity severe enough to interfere with a person’s daily functioning.

A report on the research is published in the December 2 issue of the journal Annals of Internal Medicine. “The lesson is that to have a healthy brain when you’re 70, you need to eat right and exercise when you’re 50,” said study leader Elizabeth Selvin, PhD, MPH, an associate professor of epidemiology at JHSPH. “There is a substantial cognitive decline associated with diabetes, prediabetes, and poor glucose control in people with diabetes. And we know how to prevent or delay the diabetes associated with this decline.”

While diabetes can often be controlled through medication, exercise, and changes to diet, disease prevention is the preferred goal. “If we can do a better job at preventing diabetes and controlling diabetes, we can prevent the progression to dementia for many people,” Selvin said. “Even delaying dementia by a few years could have a huge impact on the population, from quality of life to healthcare costs.”

Researchers are increasingly aware of the importance of many causes of dementia other than Alzheimer’s disease, particularly cognitive impairment linked to abnormalities in blood vessels in the brain.

“There are many ways we can reduce the impact of cerebral blood vessel disease-by prevention or control of diabetes and hypertension, reduction in smoking, increase in exercise, and improvements in diet,” said co-author A. Richey Sharrett, MD, DrPH, an adjunct professor at JHSPH. “Knowing that the risk for cognitive impairments begins with diabetes and other risk factors in midlife can be a strong motivator for patients and their doctors to adopt and maintain long-term healthy practices.”

This article was adapted from information provided by JHSPH.