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Diabetes and Prediabetes Linked to Accelerated Brain Aging, But Healthy Lifestyle May Offer Protection

Written by Andrew Le, MD

UpdatedSeptember 10, 2024

A compelling study published in Diabetes Care (2024;47(10):1–9) has revealed a significant association between hyperglycemia, seen in diabetes and prediabetes, and accelerated brain aging. Conducted by Abigail Dove and her team, the research delves into the implications of hyperglycemia on brain health and explores the potential mitigating effects of a healthy lifestyle. The full study is available for download here.

Study Purpose and Design

Recognizing diabetes as a known risk factor for dementia, researchers aimed to unravel the role of (pre)diabetes in early brain aging. Their focus was to determine whether (pre)diabetes relates to accelerated brain aging and if lifestyle modifications could shape this trajectory.

The study involved analysis of data from 31,229 dementia-free individuals aged 40 to 70, drawn from the UK Biobank. Using baseline HbA1c levels along with up to two brain MRI scans over an 11-year follow-up, they computed the brain age gap (BAG)—a metric that compares brain age against chronological age through machine learning models.

Key Findings

The findings were stark: prediabetes and diabetes were both linked to a higher BAG. Specifically, diabetes was associated with a brain age nearly 2.29 years older than the biological age and showed n further widening of the BAG annually. Notably, men and people with multiple cardiometabolic risk factors experienced more pronounced BAGs.

Lifestyle's Mitigating Role

A silver lining emerged with evidence suggesting that a healthy lifestyle could soften the blow of (pre)diabetes on brain aging. Participants with diabetes who engaged in high physical activity and avoided smoking and heavy drinking had a significantly lesser BAG, with a difference up to 1.68 years compared to those with nonoptimal lifestyle habits.

Significance and Implications

The results underscore the urgent necessity for actionable lifestyle changes to offset the detrimental effects of (pre)diabetes on brain health. This study amplifies the call for interventions focused on glycemic control and lifestyle adjustments to support brain health, particularly in individuals tagged "at risk" due to diabetes or prediabetes.

Study's Strength and Considerations

While the study capitalizes on a robust sample size and multimodal brain MRI data, the authors acknowledge limitations such as UK Biobank's potential healthy volunteer bias and the lack of dietary data integration into the lifestyle analysis. Nevertheless, the findings stand as a pivotal reminder of the interconnectedness of metabolic health and brain function.

Conclusion

Anxiety about diabetes-related brain decline might be somewhat assuaged by this study's revelation that brain-healthy lifestyle choices could effectively combat the threat. This information serves as a beacon for those with (pre)diabetes, indicating that it's not just the glycemic numbers that matter, but also how one leads their life.

For further insight into this groundbreaking study, you can access the full text here.

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References

Dove, A., Wang, J., Huang, H., Dunk, M. M., Sakakibara, S., Guitart-Masip, M., Papenberg, G., & Xu, W. (2024). Diabetes, Prediabetes, and Brain Aging: The Role of Healthy Lifestyle. Diabetes Care, 47(10), 1–9. https://doi.org/10.2337/dc24-0860