Having optimal cardiovascular health may offset the risk of developing mild cognitive impairment and dementia for people with Type 2 diabetes (T2D), 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, Nov. 7-10, in New Orleans.
The study examined health and genetic data from more than 40,000 dementia-free adults with Type 2 diabetes in the UK Biobank. Researchers assessed the joint effects of cardiovascular health, based on the American Heart Association’s Life’s Essential 8 metrics, and a genetic risk for dementia on the risk of developing mild cognitive impairment and dementia over 13 years.
Life’s Essential 8 includes eight components for ideal heart and brain health: eat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood sugar, and manage blood pressure. The study classified cardiovascular health as high (score 80-100), moderate (50-79), or low (0-49).
During the follow-up period, 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 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 developing mild cognitive impairment and a 23% lower risk of developing dementia compared to those with low cardiovascular health. Better cardiovascular health scores were also positively associated with brain volume, indicating maintained brain structure.
“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. “That means, if you have a family history of Alzheimer’s or cognitive impairment, you can make modifiable lifestyle changes that may help protect yourself.”
“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.
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 highlights the potential for cardiovascular health interventions to mitigate dementia risk in this high-risk population.
The researchers noted limitations, including the observational nature of the study, which cannot establish cause and effect. Additionally, most people do not undergo genetic testing for dementia risk, so they may be unaware of their susceptibility.
“In the past, we focused on the message: live healthy, live long. However, it’s not just living long, it’s living long and maintaining our cognitive function and capacity for longer independence and better quality of life. Our study’s findings support that you can do both,” said study corresponding author Yilin Yoshida, Ph.D., M.P.H., FAHA, assistant professor at Tulane University School of Medicine.
