Can dementia be prevented? There is no shortage of theories about what may help (solve puzzles, eat fish, drink fruit juice and/or coffee, take up dancing, meditate, learn a new language, and so on) but, unfortunately, there’s not a lot of research to back them up. It’s a difficult subject to investigate. It would be impractical, for example, to take a large group of 50-year-olds, split it into two halves, have one group complete a daily crossword puzzle while the other group does not, and wait 30 years to see who develops dementia. Now, however, a new study suggests that a healthy lifestyle that minimizes risk factors really can help people with diabetes ward off dementia. The report was published in the journal Diabetes Care.
The researchers took their data from what’s known as the UK Biobank Study, which was launched in 2006 and is a large biomedical database and research resource that contains genetic and health information on half a million people aged between 40 and 69 who live in the United Kingdom. Participants regularly contribute blood, urine, and saliva samples as well as lifestyle information to help analysts understand how they deal with disease. The database is open to qualified researchers from around the world.
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The research team, which was headed by Thomas van Sloten, MD, of the Maastricht University Medical Center in the Netherlands, collected data from the Biobank Study on 10,633 people with type 2 diabetes and 77,193 controls who didn’t have diabetes with the express purpose of investigating the relationship between diabetes and dementia. As Dr. van Sloten told the medical news service MedPage Today, “The effect on current management of type 2 diabetes on the risk of dementia is incompletely understood…. We therefore wanted to investigate to what extent dementia in individuals with diabetes can be potentially prevented by targeting multiple risk factors.” The average time of follow-up was nine years, after which 1.4% of the subjects with diabetes were diagnosed with dementia, while only 0.5% of the control group were. The subjects’ brain changes were measured by use of magnetic resonance imaging (MRI) scans and the use of memory and reaction tests.
Seven important dementia risk factors
The researchers identified seven risk factors as particularly relevant: smoking, HbA1c levels, blood pressure, body-mass index (BMI, a measure of obesity), physical activity, diet, and albuminuria (a sign of kidney disease). The researchers didn’t take into account the possible role of cholesterol because the results of research in that area were “inconsistent.”
They then determined that people with diabetes who kept five to seven of these risk factors within the recommended target range had no more risk of dementia than the controls, even though those with diabetes overall had a higher risk of dementia. That is, among the people with diabetes, “excess dementia risk decreased stepwise for a higher number of risk factors on target.” The researchers also reported that “Differences in processing speed, executive function, and brain volumes were progressively smaller for a higher number of risk factors on target.” In other words, a person with four risk factors on target had a much lower chance of developing dementia than a person with zero to three. Dr. van Sloten commented that the physical changes that accompany diabetes-related dementia are probably the result of several causes and among these causes are “large vessel disease, microvascular dysfunction, and neurodegeneration.”
The results of their study, the researchers said, demonstrated the importance of “multifactor risk factor treatment strategies in diabetes” and they encouraged doctors “to encourage adoption of healthy habits among their patients.” The specific targets to aim for were:
- HbA1c below 7%
- Blood pressure below 130/80 mmHg
- BMI of 20 to less than 25
- Absence of albuminuria
- At least 150 minutes a week of “moderate-to-vigorous” physical activity
- A healthy diet
- Not smoking
Want to learn more about maintaining cognitive health with diabetes? Read “Nine Tips to Keep Your Memory With Diabetes,” “Keeping Your Brain Strong With Diabetes” and “Memory Fitness: How to Get It, How to Keep It.”