Type 2 diabetes is associated with a variety of health concerns, ranging from eye and foot issues to an increased risk for heart disease, high blood pressure, and stroke. There's also another, relatively new concern among people with type 2 diabetes: dementia and cognitive decline.
An increased dementia risk is especially alarming considering 5.4 million Americans have Alzheimer’s and another 16 million cases are predicted over the next 40 years. At the same time, almost 26 million Americans have diabetes while 80 million more are at a high risk for the disease. Put these two trends together, and it’s obvious that healthy brain gains are crucial for long-term health.

Why Is Type 2 Diabetes Linked to Dementia?

In one study, researchers found that elderly people with type 2 diabetes experience two and a half times the amount of the natural brain shrinkage that comes with age than their non-diabetic peers, possibly due to changing blood-sugar levels. Most of this loss was in the frontal lobe, where higher mental functions occur.
Another possible explanation for the link is that diabetes increases the production of amyloid — clusters of protein fibers — in the brain. The buildup of amyloid in the brain is an ongoing subject of Alzheimer’s research. Another hypothesis is that damage to the brain caused by hypertension, stroke, heart attack, or low oxygen levels from sleep apnea — which are all more likely to occur in people with type 2 diabetes — contribute to dementia risk. The metabolic effects of chronic fluctuations in blood sugar could also affect brain health.
“There are a number of ways the brain is affected by the aging process, and these mechanisms are mimicked by the physiological effects of type 2 diabetes,” notes James T. Lane, MD, the Harold Hamm Chair in clinical diabetes research at the Harold Hamm Diabetes Center in Oklahoma City.
Recent research published in the journal Diabetes Care indicates a possible link between diabetes and Parkinson’s disease, a degenerative, neurological disorder. The investigators found that people with diabetes were more likely to develop Parkinson’s disease, particularly women and younger people. Dr. Lane cautions, however, that many more studies need to be done before a definitive association can be confirmed.

Protecting Brain Health Through Better Diabetes Management

“The best prevention for complications [of diabetes], including dementia, is good diabetes management,” says Mary Vaccarello-Cruz, MD, a pediatric endocrinologist and medical director of the Florida Atlantic University Diabetes Education & Research Center in West Palm Beach. Fortunately, simple, basic steps are all you need — daily exercise, healthy eating, and sticking with any medical therapy prescribed by your doctor can help offset dementia risk.
In particular, antioxidant-rich foods, such as berries, vegetables, nuts, and grains, promote brain health. Drinking coffee or other foods with caffeine might also provide a moderate cognitive benefit, though more research is needed to determine an exact amount.
Your lifestyle habits also should include some fun and games for your brain, specifically puzzles, card games, and logic quizzes, advises Naheed Ali, MD, author of Diabetes and Youand Understanding Alzheimer’s. Research indicates that flexing your brain’s thinking muscles through games can help you stay sharp.
Finally, staying educated about diabetes and working closely with your medical team for the best diabetes management plan will enhance all aspects of your health.