Type 2 Diabetes is raging across the United States. It is responsible for a variety of risk factors including heart disease. Add dementia to the list of growing concerns. Middle-aged patients with uncontrolled type 2 diabetes are at a greater risk of various measures of cognitive decline.

Published in the Annals of Internal Medicine, a team led by Dr. Elizabeth Selvin, from the Johns Hopkins School of Public Health, analyzed data on 13,351 patients enrolled in the Atherosclerosis Risk in Communities (ARIC) study. Ages used in the study ranged from 48 to 67. So, there’s a silver lining here. Science says the new 40 is 48. Good news for those thinking midlife crisis.

Cognitive decline due to diabetes is all about control. You hear the mantra of healthier diet and lifestyle. Follow the advice. Dr. Selvin lays out the issue in the study.

“Diabetes and glucose control are potentially modifiable and may offer an important opportunity for the prevention of cognitive decline, thus delaying progression to dementia,” Selvin said. “At the population level, delaying the onset of dementia by even a couple of years could reduce its prevalence by more than 20% over the next 30 years.”

Researchers used three neuropsychological tests to get a read on cognitive function during the ARIC study:

Delayed Word Recall Test (DWRT)

Digit Symbol Substitution Test (DSST)

Word Fluency Test (WFT)

Tests showed that those with diabetes had significant declines in both the DSST and WDT. The DWRT scores did not show a statistically significant change in either direction.

The decline in both the WFT and DSST show impairments in processing speed and executive function in the brain. Both declines point to an association of diabetes and cognitive function “may involve the subcortical microvasculature that damages white matter pathways or subcortical gray matter in other ways.”

The longer a patient had diabetes, the greater the decline showed in cognitive Z-scores.

How do you prevent it? For one, avoid getting type 2 diabetes. Prevention is the best medicine. If you do have diabetes, it’s all about listening to the bookshelf of advice. Control your glucose levels. Choosing between a piece of cake and cognitive function is an easy one. Besides, kicking ass on Wheel of Fortune one day sounds much better than pretending you actually like that pie.

The complete study is in the latest issue of the Annals of Internal Medicine.

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