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Midlife Diabetes Could Increase Risk of Cognitive Decline

Poor glucose control speeds progression of dementia…

A new study by researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, suggests that a midlife diagnosis of diabetes may accelerate the rate of cognitive decline over the following 20 years. Elizabeth Selvin, PhD, and her research team analyzed the data from Atherosclerosis Risk in Communities Study involving 15,792 middle-ages adults who have been followed since 1987.

Participants were assessed over four visits that took place every 3 years between 1987-1998, while an additional fifth assessment was conducted between 2011 and 2013. On three of these assessments, cognitive function was also analyzed, which was then compared to the rate of cognitive decline among study participants with the rate of age-related cognitive decline among the general population.

The results showed that the participants with poorly controlled diabetes were 19% more likely to experience cognitive decline, reduced memory, word recall, and executive functioning compared to participants of that same age without diabetes. The team found that participants with controlled or prediabetes were also at an increased risk of cognitive decline than age-matched, healthy individuals, although the increased risk among these populations was smaller than that found among participants with poorly controlled diabetes.

The solution? Eat right, exercise at age 50 and have a healthy brain at age 70. Around 29.1 million Americans, approximately 9.3% of the U.S. population, have diabetes, while 86 million Americans age 20 and older have prediabetes. According to Selvin, the team’s results emphasize the importance of controlling diabetes through a combination of exercise, weight control and a healthy diet.

“If we can do a better job at preventing diabetes and controlling diabetes, we can prevent the progression to dementia for many people,” stated Selvin. “Even delaying dementia by a few years could have a huge impact on the population, from quality of life to health care costs.”

Practice Pearls:

  • This study predicts an association with midlife diabetes diagnosis and early cognitive decline
  • Participants with poorly controlled diabetes were 19% were more likely to experience cognitive decline
  • The solution is to eat right, exercise at 50 and have a healthy brain at 70

Diabetes in midlife and cognitive change over 20 years: the Atherosclerosis Risk in Communities Neurocognitive Study, Elizabeth Selvin, et al., Annals of Internal Medicine, published online 1 December 2014.