Having 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, according to a preliminary study to be presented at the American Heart Association’s Scientific Sessions 2025.
The study, which examined health and genetic data from more than 40,000 dementia-free adults with Type 2 diabetes in the UK Biobank, assessed the joint effects of cardiovascular health—based on the Life’s Essential 8 metrics—and genetic risk for dementia on the development of 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. The researchers classified cardiovascular health as high (score 80-100), moderate (50-79), or low (0-49).
During follow-up, 840 participants developed mild cognitive impairment and 1,013 developed dementia. After adjusting for age, sex, and race, those with moderate or high cardiovascular health had a 15% lower risk of both mild cognitive impairment and dementia compared to those with low cardiovascular health. Among participants with a high genetic risk for dementia, those with moderate or high cardiovascular health had a 27% lower risk of mild cognitive impairment and a 23% lower risk of dementia.
“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. The findings also showed that better cardiovascular health scores were associated with greater brain volume, which is typically lost during cognitive decline.
An analysis of U.S. adults from the National Institutes of Health’s All of Us Research Hub showed similar trends, with 667 adults developing mild cognitive impairment and 538 developing dementia over 15 years.
The researchers noted the study was observational and cannot establish cause and effect. However, the findings underscore the importance of cardiovascular health in preserving cognitive function. “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,” said Hugo Aparicio, M.D., M.P.H., FAHA, volunteer chair of the American Heart Association’s Stroke Council Brain Health Committee, who was not involved in the study.
