A major study using brain MRI scans of more than 31,000 adults suggests that type 2 diabetes and prediabetes may lead to accelerated brain aging.
People with diabetes, especially when it was uncontrolled, had brains that were significantly older than their chronological age. However, lifestyle choices such as exercising and avoiding smoking and excessive drinking can mitigate these effects.
Diabetes, prediabetes and brain aging
Type 2 diabetes is a known risk factor for dementia, but it’s unclear how diabetes and its early stages, called prediabetes, affect brain aging in people without dementia. Now, a comprehensive brain imaging study shows that both diabetes and prediabetes may be linked to accelerated brain aging.
The study involved more than 31,000 people aged 40 to 70 from the UK Biobank who had undergone brain MRI (magnetic resonance imaging) scans. The researchers used a machine learning approach to estimating brain age relative to a person’s chronological age.
Impact of diabetes control on brain age
Prediabetes and diabetes were associated with brains that were 0.5 and 2.3 years older than chronological age, respectively. In people with poorly controlled diabetes, brains appeared more than four years older than chronological age. The researchers also noted that the gap between brain age and chronological age increased slightly over time in people with diabetes. These associations were attenuated in people who were highly physically active and who abstained from smoking and heavy alcohol consumption.
Perspectives for study and future research
“Having a brain that appears older than its chronological age may indicate a deviation from the normal aging process and may be a precursor to dementia,” says Abigail Dove, lead author of the study and a doctoral student in the Department of Neurobiology, Health Sciences and Society at Karolinska Institutet. “On the positive side, it seems that people with diabetes can influence their brain health by adopting a healthy lifestyle.”
Repeat MRI data were available for a small proportion of study participants. Follow-up MRI scans are ongoing, and researchers continue to study the link between diabetes and brain aging over time.
Implications for prevention and management
“The prevalence of type 2 diabetes is high and increasing in the population,” says Abigail Dove. “We hope our research will help prevent cognitive impairment and dementia in people with diabetes and prediabetes.”
Reference: “Diabetes, Prediabetes, and Brain Aging: The Role of Healthy Lifestyle” by Abigail Dove, Jiao Wang, Huijie Huang, Michelle M. Dunk, Sakura Sakakibara, Marc Guitart-Masip, Goran Papenberg, and Weili Xu, August 28, 2024, Diabetes care.
DOI: 10.2337/dc24-0860
The study was mainly funded by the Swedish government. Alzheimer’s disease Foundation, the Dementia Research Fund, the Swedish Research Council and Forte (the Swedish Research Council for Health, Working Life and Welfare). No conflicts of interest were reported.
