Diabetes has already been associated with a number of health maladies but findings of a new research add another reason to make lifestyle changes that could reduce the odds of developing the disease.

A study conducted by Elizabeth Selvin, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues suggests that those who have diabetes in midlife are more likely to have worse cognitive decline later in life compared with those who do not have the condition giving credence to earlier studies that found an association between type 2 diabetes and dementia.

For their study published in the journal Annals of Internal Medicine on Dec. 2, the researchers followed over 13,000 individuals who were 57 years old on average for a period of over 20 years. Of the participants, 1,800 had diabetes and mostly had the lifestyle- associated type 2 diabetes.

The researchers assessed the participants' brain health five times during the study period. By testing how fast they process new information and evaluating their short term memory and verbal learning ability, the researchers found that those who have diabetes at the start of the study exhibited cognitive decline 19 percent worse than those who did not have the condition. Diabetics with poorly controlled sugar levels likewise exhibited more cognitive decline than their counterparts whose diabetes is controlled.

"Diabetes in midlife was associated with a 19% greater cognitive decline over 20 years compared with no diabetes," Selvin and colleagues wrote. "Participants with poorly controlled diabetes had greater decline than those whose diabetes was controlled. Longer-duration diabetes was also associated with greater late-life cognitive decline."

Lawrence Reagan, from the University of South Carolina School of Medicine in Columbia who studies the effects of weight problems and diabetes on the brain, said that several factors associated with diabetes can result in cognitive decline and dementia. Poor control of the body's sugar level, for instance could eventually lead to a decrease in neurosplasticity and this can make the brain work as if it were older.

Type 2 diabetes, the most prevalent form of the disease, is associated with obesity and unhealthy lifestyle. Lifestyle changes can reduce the odds of developing the condition. Gail Musen, from the Joslin Diabetes Center in Boston, said that the study stresses the importance of people caring for themselves during midlife.

"Take care of yourself in midlife, because even small differences in glucose levels, which can be modified by diet, exercise and lifestyle, will affect your brain and cognition when you're older," Musen said.

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