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A major study using brain MRIs from over 31,000 adults suggests that type 2 diabetes and prediabetes may lead to accelerated brain aging.
Those with diabetes, especially when uncontrolled, showed brains that were significantly older than their chronological age. However, lifestyle choices like exercise and avoiding smoking and excessive drinking may mitigate these effects.
Diabetes, Prediabetes, and Brain Aging
Type 2 diabetes is a known risk factor for dementia, but it is unclear how diabetes and its early stages, known as prediabetes, affect brain aging in people without dementia. Now, a comprehensive brain imaging study shows that both diabetes and prediabetes can be linked to accelerated brain aging.
The study included more than 31,000 people between 40 and 70 years of age from the UK Biobank who had undergone a brain MRI scan (magnetic resonance imaging). The researchers used a machine learning approach to estimate brain age in relation to the 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, the brain 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 among people with high physical activity who abstained from smoking and heavy alcohol consumption.
Study Insights and Future Research
“Having an older-appearing brain for one’s chronological age can indicate deviation from the normal aging process and may constitute an early warning sign for dementia,” says the study’s lead author Abigail Dove, a PhD student at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet. “On the positive side, it seems that people with diabetes may be able to influence their brain health through healthy living.”
Repeated MRI data were available for a small proportion of the study participants. Follow-up MRI scans are ongoing and researchers are now continuing to study the association between diabetes and brain ageing over time.
Implications for Prevention and Management
“There’s a high and growing prevalence of type 2 diabetes in the population,” says Abigail Dove. “We hope that 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, 28 August 2024, Diabetes Care.
DOI: 10.2337/dc24-0860
The study was mainly funded by the Swedish Alzheimer’s Foundation, the Dementia Research Fund, the Swedish Research Council, and Forte (the Swedish Research Council for Health, Working Life and Welfare). There are no reported conflicts of interest.
1 Comment
“These associations were attenuated among people with high physical activity who abstained from smoking and heavy alcohol consumption.” This is confusing. If diabetes is associated with aging brains, but this effect disappears when the person has a “good” lifestyle, then diabetes, per se, is not associated with brain aging. The lifestyles are. Put differently, if a person with pre-diabetes has a good lifestyle, then there is no effect from the pre-diabetes on the brain. If they have a bad lifestyle, then there is an effect on the brain. This means alcohol consumption (which obviously ages the brain) and smoking (which also may age the brain) and being sedentary (which lowers circulation overall), could be the factors here, and not diabetes, since diabetes or pre-diabetes alone, without a bad lifestyle, do not cause this brain aging effect. That’s why this article says you can mitigate this diabetes effect on the brain with a better lifestyle. But it means the problem is the lifestyle, not the diabetes.
On the other hand, the reason why some studies have found an association with diabetes and an aging brain could be because type-2 diabetics (which is what we are considering here, not type-1), is often created by a over-eating and having a sedentary lifestyle, which makes people fat. Alcohol also does this, especially beer. So the typical type-2 diabetic is probably overweight, or obese. Being obese increases intracranial pressure, or pressure inside the brain, especially when lying down. Obesity, in other words, causes increased brain pressure. If lying too flat, the brain does not get enough circulation, which lowers oxygen and sugar availability in the brain. Both excessive brain pressure and poor brain circulation can age the brain.
You can deal with this in a simple way, by elevating the head of the bed about 10-30 degrees, as you would with a wedge for GERD or acid reflux. You need the assistance of gravity for proper brain circulation. You can also prop up the head of the bed with blocks beneath the legs, or use an adjustable bed. NASA research shows that head of bed elevation improves brain circulation, which is a problem for astronauts in zero gravity. On Earth, they study zero gravity by having people lie flat.
My sleep research, as a medical anthropologist, found that this simple sleep position change can stop migraines, sleep apnea, glaucoma, stroke, dementia, and more. It also clears the sinuses in the morning, and reduces the amount of sleep you need. People wake up refreshed and more alert with the head of the bed elevated. (Just another pillow will not work.) See my article, Heads Up! The Way you are Sleeping can be Killing You.
https://www.academia.edu/1483361/Heads_Up_The_Way_You_Are_Sleeping_May_Be_Killing_You_