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Cardiovascular Health May Shield Diabetics From Cognitive Decline, Even With Genetic Risk
Maintaining optimal heart health could considerably lower the risk of mild cognitive impairment and dementia for individuals with Type 2 diabetes, even those predisposed to cognitive decline through genetics, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2025, held November 7-10 in New Orleans. The findings suggest that lifestyle and health factors can play a crucial role in protecting brain health,offering a beacon of hope for millions living with diabetes.
According to the American Heart Association’s 2025 Heart Disease and Stroke Statistics Update, Type 2 diabetes is linked to diminished cognitive function and accelerated cognitive decline. This new study delved into the combined influence of cardiovascular health – measured by the Association’s Life’s Essential 8 (LE8) – and genetic predisposition to dementia on the risk of cognitive impairment in adults with Type 2 diabetes.
Life’s Essential 8 encompasses eight key components of ideal heart and brain health: eat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood sugar, and manage blood pressure.These factors, categorized as health behaviors and health factors, provide a thorough assessment of cardiovascular well-being.
“there are multiple factors associated with Type 2 diabetes that contribute to an increased risk of cognitive decline, including chronic inflammation, insulin resistance, and vascular damage,” explained study author Michelle Yoshida, Ph.D., M.P.H., an assistant professor of epidemiology at Tulane University School of Public Health and Tropical Medicine.”We wanted to understand how much of that risk could be mitigated by optimizing cardiovascular health.”
The study involved analyzing data from over 12,000 adults with type 2 diabetes from the UK Biobank.Researchers categorized participants based on their genetic risk score for dementia and their cardiovascular health score.The results revealed a stark contrast: individuals with low cardiovascular health faced a significantly higher risk of mild cognitive impairment and dementia compared to those with low cardiovascular health.
Notably, among participants with a high genetic risk score, those maintaining moderate or high cardiovascular health experienced a 27% lower risk of mild cognitive impairment and a 23% lower risk of dementia, again compared to those with low cardiovascular health. Furthermore, higher cardiovascular health scores correlated positively with brain volume, suggesting that individuals adhering to the Life’s Essential 8 principles were more likely to preserve brain volume – a critical factor as loss of brain volume is associated with cognitive decline. A similar trend was observed in an analysis of U.S. adults.
“genes are not destiny,” asserted Xiu Wu, Ph.D., a postdoctoral fellow at Tulane University and the study’s first author. “Maintaining optimal cardiovascular health can protect brain health even for people with Type 2 diabetes who carry the highest genetic risk for dementia. That means, if you have a family history of Alzheimer’s or cognitive impairment, you can make the modifiable lifestyle changes that may help protect yourself.”
Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association’s Stroke Council Brain Health Committee, echoed this sentiment. “It’s another great example of what’s good for the heart is good for the brain, even when yoru genes might potentially be stacked against you,” said Aparicio, who was not involved in the study and is an associate professor of Neurology at Boston University Chobanian & Avedisian School of medicine.
The researchers acknowledged limitations, noting the observational nature of the study prevents establishing a direct cause-and-affect relationship. they also pointed out that widespread genetic testing for dementia risk is not currently standard practice. However, Yoshida emphasized a shift in perspective: “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. Our study’s findings support that you can do both.”
The study utilized data from the UK Biobank, a large-scale biomedical database encompassing health and genetic information from over 500,000 adults in the United Kingdom, and supplemented this with data from over 20,000 dementia-free adults from the National Institutes of Health’s All of Us Research Hub to ensure representation of a U.S. population. Cardiovascular health was assessed based on scores ranging from 0-100, with low health defined as 0-49, moderate as 50-79, and high as 80-100, utilizing data collected over multiple assessment periods between 2006 and 2019.
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