Diabetes, Abdominal Obesity, and Cognitive Decline

It seems that no part of the body is unaffected by diabetes and the complications that come with it. 

Heart, foot, eye, and kidney problems are all well known to those living with type 2. Now, it seems, we can add dementia and cognitive decline to that list as well.

According to a recent study, people with type 2 diabetes under the age of 88 with abdominal obesity and even moderately elevated blood sugars are at an increased risk for rapid cognitive decline.

In this article, we will look at the findings of this study and discuss why this association exists as well as some steps you can take to lower your risk for diabetes-related cognitive complications.

A1c, Adiponectin, and Cognitive Decline

The study, which was published in The Journal of American Geriatrics Society, compared participants’ neuropsychological test scores with measures that included HbA1c, insulin resistance, obesity, and waist-to-hip-ratio (WHR).

The researchers found that participants under the age of 88 with high WHR (increased abdominal obesity) and an A1c of 6.2% or greater, were at an elevated risk for faster cognitive decline.

This association did not exist in people with diabetes who had a low WHR. However, the researchers did find these participants had an increased risk of cognitive decline if their adiponectin levels were elevated.

Adiponectin is a protein hormone involved in glucose regulation. Levels are more likely to be elevated in non-obese people suffering from heart failure, hypertension, and chronic inflammatory diseases.

These findings support previous studies that indicate type 2s have a 1.5 times greater risk of hastened cognitive decline compared to people who do not have diabetes. All-cause dementia appears to be even more strongly associated with diabetes, with research indicating type 2s have a 2 to 2.5 greater chance of developing dementia.

How Does Diabetes Affect the Brain?

The most likely link between cognitive decline and diabetes lies in the well-known complication of microvascular damage.

Microvascular damage occurs when the body experiences elevated blood sugars and insulin resistance. Both of these factors cause increased oxidative stress on small blood vessels which can lead to restricted blood flow to certain areas of the body including the eyes, kidneys, and brain.

When blood flow is restricted to the brain, nerve cells can die off.

Additional damage to the brain can occur during both extremely high and low blood sugar events. It has even been found that the brains of people who have diabetes work differently when blood sugar is relatively stable compared to people without diabetes.

It is also possible that the overlap of oxidative stress, inflammation, and mitochondrial dysfunction that occurs in both people with diabetes and people with dementia may play into the increased risk.

Similarly, diabetes risk and dementia risk both increase with age which may explain some of the overlap in risk between the two conditions.

How to Decrease Your Cognitive Decline Risk

As someone living with type 2 diabetes, it is possible to take steps to reduce your risk of early and rapid cognitive decline. While it is most effective to begin this work before signs of cognitive decline are present, even those already suffering some issues will benefit.

• Work to shed excess weight, especially around your midsection.
• Increase your activity levels and establish a consistent exercise routine.
• Shoot for a goal A1c of 6.1% or lower.
• Work to get better sleep and aim for 7 hours per night.
• Eat a diet high in fruits and vegetables to help reduce oxidative damage in your body.

Most importantly, if you suspect you are experiencing some cognitive decline, talk to your doctor right away. While there is currently no cure for Alzheimer’s or dementia, early intervention can help slow the progression of the disease and help you find ways to cope with your changing cognitive abilities.