Type 2 Diabetes May Accelerate Cognitive Decline, Research Shows

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Those who have type 2 diabetes are at risk for developing health issues like sight impairment, heart disease, kidney disease—and accelerated aging of the brain. Research shows that those who have type 2 diabetes are twice as likely to experience early cognitive decline compared to those who don’t have type 2 diabetes.

A recent study from the United Kingdom found the areas of the brain that are most impacted are those responsible for executive function and processing speed.

“Executive functioning skills refer to time management skills, concentration skills, organizational skills, adaptability skills,” says Rebecca Simon, D.O., an endocrinologist at Henry Ford Health. “Processing speed refers to the length of time it takes to comprehend information. There are theories as to why those with type 2 diabetes may experience accelerated brain aging, but it’s not definitively known. However, significant research does show that it contributes to early cognitive decline.”

How Type 2 Diabetes May Contribute To Accelerated Brain Aging

Along with general cognitive decline, those with type 2 diabetes are at an increased risk for Alzheimer’s dementia and vascular dementia (or dementia caused by a lack of blood flow to the brain, which can potentially occur after a stroke). There are several theories as to how type 2 diabetes is linked with cognitive decline:

  • Type 2 diabetes causes insulin resistance, and insulin resistance decreases insulin production in the brain, which can contribute to cognitive decline (as insulin helps to regulate cognitive function).
  • Type 2 diabetes can cause high glucose levels, and high glucose levels have been associated with the atrophying—or shrinking—of the hippocampus. (That’s the area of the brain that’s largely responsible for memory and learning.)
  • Obesity is a risk factor for cognitive decline, and many people who have type 2 diabetes are also obese.
  • High blood pressure is associated with cognitive decline and many people who have type 2 diabetes also have high blood pressure.

“When looking at the relationship between cognitive decline and type 2 diabetes, there are a lot of confounding factors,” says Dr. Simon. “Is it actually obesity and not type 2 diabetes itself? Or is it high blood pressure? We’re not 100% clear on the mechanism behind type 2 diabetes and cognitive decline.”

Is Type 1 Diabetes Associated With Cognitive Impairment?

Most of the studies on cognitive decline focus on type 2 diabetes—there isn’t quite as much data on type 1 diabetes. “That said, there are studies that have noted increased risks for dementia in patients with type 1 diabetes over the age of 50,” says Dr. Simon. “The highest risks are in patients who have extreme blood sugar highs and lows.”

Reducing Your Risk For Cognitive Impairment

Research shows that the longer you have type 2 diabetes, the more severe the cognitive effects can be. That said, taking steps to control type 2 diabetes may make a difference in cognitive decline.

“There are so many factors that contribute to cognitive impairment, so many variables in dementia,” says Dr. Simon. “But in general, high-risk patients are those with high blood pressure, vascular disease, obesity, uncontrolled diabetes and those who smoke.

“So the overall message here, to those with concerns about cognitive impairment, is to lead a healthy lifestyle. Keeping your weight down can actually reverse symptoms of type 2 diabetes. Eat a balanced diet, exercise each day, stay on top of any medications you need with the help of your doctor. A healthy lifestyle is the first, second and third line of treatment.”


To learn more about diabetes prevention and management, or to book an appointment with a diabetes specialist, visit henryford.com/services/diabetes.

Rebecca Simon, D.O., is an endocrinologist at Henry Ford Health. She sees patients at Henry Ford Medical Center—Bloomfield Township and Henry Ford Medical Center—New Center One.

Categories: FeelWell