Type 2 diabetes speeds brain aging and cognitive decline

It’s common for people – especially those 70 and older – to experience cognitive decline, but for those with type 2 diabetes, this process can be accelerated dramatically.

A new study found that people with progressive type 2 diabetes can experience an acceleration of brain aging by nearly 26% compared to individuals without the disease.

“More attention needs to be allocated to research focusing on the brain and diabetes because we don’t have good diagnostic measures and we can’t really tell how much the brain is affected by diabetes,” Botond Antal, PhD, sole first author of the study and PhD student in the Biomedical Engineering Department at Stony Brook University, told SeniorsMatter. “Diabetes is usually not approached from the perspective of the brain; we’re usually looking at the peripherals, other body parts and our organs, not so much the brain.”


Key findings from the study

The researchers analyzed data on just more than 20,000 adults between 50 and 80 years old, and found that aging and type 2 diabetes both contribute to changes in executive functions, including working memory, learning and flexible thinking. However, participants with type 2 diabetes scored 13% lower on cognitive tests compared to diabetes-free people of the same age, sex and education level. Additionally, the processing speed performance was nearly 7% lower in those with diabetes.

Participants with type 2 diabetes scored 13% lower on cognitive tests compared to diabetes-free people of the same age, sex and education level.

Using MRI scans to analyze brain structure and activity, the team discovered gray brain matter decreased with age in both groups, with the biggest decrease in the area called the ventral striatum, a brain region critical for executive functions. People with diabetes suffered an additional 6.2% decrease in gray matter in the ventral striatum along with other decreases in other regions compared to diabetes-free people.

“Decreasing gray matter volume is definitely not a good thing to have because the gray matter is where the neurons are located,” Antal explained. “That’s where all the cell bodies are. If you’re losing matter there, that means you’re losing those neurons and cell bodies.”

When neurons die, especially in parts of the brain that control memory, people lose their capacity to remember things or their ability to do everyday tasks.

These findings suggest that a strong connection between normal age-related neurodegeneration (a type of disease in which cells of the central nervous system stop working or die) and type 2 diabetes-related neurodegeneration. But despite that, type 2 diabetes significantly accelerates brain aging and cognitive decline. Furthermore, the longer someone has diabetes, the more noticeable the effects on brain function will be.

Type 2 diabetes significantly accelerates brain aging and cognitive decline. Furthermore, the longer someone has diabetes, the more noticeable the effects on brain function will be.

Why does type 2 diabetes accelerate brain aging and cognitive decline?

Antal said more research is needed in this area to fully understand how diabetes can speed up cognitive decline. However, he hypothesized that when glucose levels are high, the body can’t properly use insulin – the hormone that allows body cells to consume glucose (sugar) – for energy. When blood sugar levels become chronically high, it can also damage blood vessels and nerves throughout the body.

“High blood glucose is associated with several negative mechanism effects like inflammation, and these effects can be happening in the brain, too,” he said. “If that’s the case, these are not friendly for the neuron. It could be that the neurons are dying because of the elevated glucose levels.”

He added another hypothesis could be that glucose is not being transported into the neurons. If there’s a lot of glucose in the blood (but it’s not getting into the neurons where it should be), it can cause the neurons to starve—and then become energy-deprived.

“If the neurons are energy-deprived, that could lead to functional deficits, cell death and, down the line, cognitive decline,” Antal said.

Maintenance and control of type 2 diabetes in seniors

If you or a loved one has been diagnosed with type 2 diabetes, there are a few things you can do to help them manage their disease.

This includes encouraging a healthy and balanced diet, engaging in regular physical activity, maintaining a healthy weight, tracking blood sugar levels and attending regular checkups with a doctor, Scott Kaiser, MD, a geriatrician for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California, SeniorsMatter told.

“Exercise or increased physical activity is helpful for managing and even preventing diabetes, but it’s also one of the best possible things for our brain health and our overall health longevity,” he said. “When it comes to healthy aging, exercise is the closest thing we have to a miracle drug. That goes for brain health, diabetes, management and prevention as well.”

Other ways to manage diabetes include:

  • Losing weight
  • Eating fiber-rich foods, whole grains and vegetables
  • Monitoring blood pressure and cholesterol levels
  • Quit smoking

“It’s never too late. At least you can slow it down or stop it. You may not be able to reverse it, but at least you can slow it down,” Antal said. “Treating your diabetes with conventional methods that are already out there should probably help.”

Symptoms of type 2 diabetes and ways to prevent it

Caregivers and loved ones should be alert to the signs and symptoms of type 2 diabetes, which may include:

Signs and symptoms of type 2 diabetes include:

  • Feeling very thirsty
  • Urinate often
  • Feeling very hungry despite eating
  • blurry vision
  • Extreme fatigue
  • Cuts/bruises and sores that are slow to heal
  • Weight loss without trying
  • Tingling, pain or numbness in the hands and feet

To prevent or delay type 2 diabetes, Kaiser said several prevention methods overlap with activities people could do if they already have been diagnosed. This includes being physically active, eating a well-balanced diet and maintaining a healthy weight.

Online resources are also available that introduce people to educational and lifestyle programming on how to prevent diabetes or self-manage the disease. Lastly, Kaiser said another crucial prevention measure is to encourage regular checkups with a doctor and get screened.

“The first step is for people to talk to their primary care provider about checking their brain health and take advantage of screening opportunities that become available through community organizations,” Kaiser added. “It’s so important that people be proactive and screen for diabetes, but also screen for cognitive issues.”

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