Scientists have linked prediabetes and diabetes to brain aging. Christian Charisius/picture Alliance via Getty Images Prediabetes and type 2 diabetes are both associated with an increased risk of brain-related health problems. Researchers at Karolinska Institutet used brain imaging to confirm that both diabetes and prediabetes are correlated with accelerated brain aging. Scientists have found that healthy lifestyle choices, such as quitting smoking, may help counteract the negative effects on the brain associated with diabetes.
Past research has linked both prediabetes and type 2 diabetes to an increased risk of certain brain-related health problems. For example, a study published in February 2021 linked prediabetes to increased risk of Alzheimer’s disease, cognitive decline, and vascular dementia.
“Although it is well established that diabetes is a risk factor for dementia, the role of diabetes and its preclinical condition, prediabetes, in the early stages of brain aging is unclear,” says the Center for Aging Research (ARC). said Abigail Dove, a doctoral student. from the Department of Neurobiology, Care Sciences and Society at Karolinska Institutet in Sweden, told Medical News Today. “These are important questions from a public health perspective because we need to understand how to protect brain health as people with diabetes grow older.”
Dove is the lead author of a new study recently published in the journal Diabetes Care.
This study reports that people with type 2 diabetes and prediabetes are at risk for accelerated brain aging, while making healthy lifestyle choices, such as smoking cessation, may help improve brain health. I am doing it.
For this study, Dove and her team studied MRI scans of the brains of more than 31,000 people aged 40 to 70 from the UK Biobank. At baseline, approximately 43% of study participants had prediabetes and approximately 4% had diabetes.
All participants underwent up to two brain MRI scans during the 11-year follow-up period. The researchers used a machine learning model to calculate each participant’s brain age.
In their analysis, the researchers found that both prediabetes and diabetes were associated with brains that were 0.5 and 2.3 years older, respectively, than their chronological age.
“There are several biological pathways by which prediabetes can affect brain health,” Dove explained.
“Hyperglycemia, a hallmark pathophysiological feature of diabetes, can promote endothelial dysfunction, oxidative stress, systemic inflammation, and accumulation of advanced glycation end products, which together impair the blood-brain barrier. Demyelination, the loss of axons, causes brain atrophy and disrupts neurotransmitter signaling, exposing the brain to potentially toxic substances and causing abnormal neural activity. Alterations in Ca2+ signaling lead to brain atrophy. Excitotoxicity and disruption of gene expression.”
— Abigail Dove
“Furthermore, microvascular and macrovascular complications of diabetes can lead to cerebral atherosclerosis and cerebrovascular pathology, which may lower the threshold for neurodegeneration,” she continued. . “Finally, we found that insulin resistance, a hallmark of diabetes, is associated with Alzheimer’s disease-related processes such as amyloid-beta production, tau hyperphosphorylation, and impaired amyloid-beta clearance.”
During the study, the researchers also found that the difference between brain age and chronological age increased slightly over time in people with diabetes.
However, these associations were reduced in participants who participated in vigorous physical activity, did not smoke, and refrained from heavy drinking.
“In this analysis, we were interested in whether the negative effects of diabetes on brain health could be partially alleviated by healthy lifestyle behaviors,” Dove elaborated. “Participants were divided into six groups according to glycemic status (euglycemia, prediabetes, diabetes) and lifestyle (i.e., no smoking, no heavy alcohol intake, strenuous physical activity) and non-smoking.”
“The difference between brain age and chronological age was significantly smaller in the diabetes + optimal lifestyle group than in the diabetes + suboptimal lifestyle group. This suggests that lifestyle can compensate for the negative effects of diabetes. Importantly, these findings suggest that people with diabetes can improve their brain health, as the lifestyle factors we considered, such as smoking, alcohol use, and physical activity, are all easily modifiable. Our goal is to provide actionable strategies that you can consider. ”
— Abigail Dove
After reviewing the study, Scott Kaiser, M.D., a board-certified geriatrician and director of geriatric cognitive health at the Pacific Neuroscience Institute in Santa Monica, Calif., said this was an important and well-done study and that we told MNT that the study confirms much of what we know. In terms of the importance of a healthy lifestyle and effective diabetes management when it comes to brain health and reducing dementia risk.
“There is little doubt that diabetes increases the risk and severity of dementia, among other potential negative effects. This is fairly well established. It is therefore important to consider ways to reduce that risk.” Here’s how important a brain-healthy lifestyle, which includes physical activity, avoiding smoking, avoiding excess alcohol, diet, and many other factors, is important for maintaining brain health. And it reduces the risk of dementia.”
— Dr. Scott Kaiser
“As our population ages, so too does the risk of dementia, with more than 150 million people predicted to be affected by dementia by 2050. We need to start thinking at scale about the best possible strategies for “approaches to dementia prevention.”
Kaiser noted that while the study shows an association, causation is not yet 100% established.
“I think prospective studies that demonstrate direct cause-and-effect relationships and pathways are important, but far more important is that interventions that can leverage this information (could) have a large impact.” He continued. “This study provides a very good target for lifestyle interventions to promote brain health. This is, again, very important when you think about it not only at the individual level but also at the population level.” is.”
