A preliminary study to be presented at the American Heart Association’s Scientific Sessions 2025, Nov. 7-10, in New Orleans, suggests that optimal cardiovascular health may offset the risk of developing mild cognitive impairment and dementia for people with Type 2 diabetes, even among those with a high genetic risk for cognitive decline. The study, which analyzed health and genetic data from the UK Biobank for over 40,000 dementia-free adults with Type 2 diabetes, found that following the American Heart Association’s Life’s Essential 8 metrics can protect brain health.
According to the American Heart Association’s 2025 Heart Disease and Stroke Statistics Update, Type 2 diabetes is associated with worse cognitive functioning and faster cognitive decline. This study examined the combined impact of cardiovascular health, based on Life’s Essential 8, and a high genetic risk for dementia on the risk of developing mild cognitive impairment and dementia over 13 years. Life’s Essential 8 includes eight components: eat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood sugar, and manage blood pressure.
During the 13-year follow-up, 840 participants developed mild cognitive impairment and 1,013 developed dementia. After adjusting for age, sex, and race, participants with moderate or high cardiovascular health had a 15% lower risk of developing mild cognitive impairment and a 15% lower risk of developing dementia compared to those with low cardiovascular health. Among participants with a high genetic risk score, those with moderate or high cardiovascular health had a 27% lower risk of mild cognitive impairment and a 23% lower risk of dementia compared to those with low cardiovascular health. Better cardiovascular health scores were also positively associated with brain volume, suggesting maintained brain health.
“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. Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association’s Stroke Council Brain Health Committee, added, “It’s another great example of what’s good for the heart is good for the brain, even when your genes may be stacked against you.”
The researchers noted limitations, including the observational nature of the study, which cannot establish cause and effect. However, the findings highlight the importance of modifiable lifestyle changes. As study corresponding author Yilin Yoshida, Ph.D., M.P.H., FAHA, stated, “Maintaining optimal cardiovascular health can protect brain health even for people with Type 2 diabetes who carry the highest genetic risk for dementia.”
