Optimal Cardiovascular Health May Help Offset Dementia Risk Among Adults With Type 2 Diabetes

For adults living with type 2 diabetes (T2D), good cardiovascular health could play a critical role in protecting the brain from cognitive decline. The findings are part of a larger scientific program delivered at the American Heart Association (AHA) Scientific Sessions 2025 in New Orleans. Scientists discovered that ideal cardiovascular health—measured by the AHA’s Life’s Essential 8 metrics—could lower the chances of mild cognitive impairment (MCI) and dementia occurring in a population set with a high genetic risk for cognitive decline.

AHA's 2025 Heart Disease and Stroke Statistics Update highlights that individuals with T2D have an increased probability of suffering from impaired cognitive function and rapid decline. As a result, the present study explored whether better cardiovascular health might account for such an enormous risk reduction, singling out the interplay between lifestyle factors and genetic susceptibility to dementia in this context.

The research team, headed by Yilin Yoshida, PhD, MPH, FAHA, an assistant professor of medicine at Tulane University School of Medicine, analyzed data from more than 40,000 adults with T2D from the UK Biobank who were dementia-free at baseline. Participants were followed for 13 years, during which the researchers assessed their cardiovascular health using LE8 metrics. This measure includes 4 health behaviors (healthy eating, physical activity, tobacco cessation, and sleep) and 4 health factors (body weight, cholesterol, blood pressure, and blood glucose). Cardiovascular health was classified as good, moderate, or poor based on the composite LE8 scores.

To account for genetic predisposition, investigators applied an Alzheimer’s disease–based polygenic risk score and stratified participants into low, moderate, and high genetic risk categories. Outcomes assessed included incident cases of MCI and dementia.

Key Findings

Over the 13 year follow-up, 840 participants were diagnosed with MCI and 1,013 with dementia. The scientists, after controlling for age, sex, and race, concluded that individuals with moderate or high cardiovascular health had a 15% reduced risk of both MCI and dementia incidence in comparison to individuals with poor cardiovascular health.

The advantages were significant in people with a high genetic risk for dementia. In this subgroup, maintaining good cardiovascular health at a moderate or high level was associated with a 27% reduction in the risk of MCI and a 23% reduction in the risk of dementia. Higher LE8 scores were very significantly correlated with retained brain volume—an essential indicator, as brain shrinkage is the most prominent characteristic of neurodegenerative disease.

“People with type 2 diabetes tend to have more obesity, higher blood pressure, and insulin resistance,” Yoshida said. “Controlling all those factors improves cardiovascular health and, as our findings suggest, may also help protect cognitive function.”

Study first author Xiu Wu, PhD, a postdoctoral fellow at Tulane University, emphasized the broader implications: “Genes are not destiny. Maintaining optimal cardiovascular health can protect brain health even for people with type 2 diabetes who carry the highest genetic risk for dementia.”

External experts echoed that sentiment. “It’s another great example of what’s good for the heart is good for the brain, even when your genes may be stacked against you,” said Hugo Aparicio, MD, MPH, FAHA, associate professor of neurology at Boston University and chair of the AHA’s Stroke Council Brain Health Committee, who was not involved in the study.

Clinical Implications and Limitations

The study supports the notion that adherence to the AHA’s Life’s Essential 8—through improved diet, regular activity, adequate sleep, and management of metabolic risk factors—may be an accessible and effective strategy for preserving cognitive health in people with diabetes. Although observational in nature, the findings underscore the interconnectedness of cardiovascular and brain health.

“In the past, we focused on the message: live healthy, live long,” Yoshida said. “However, it’s not just about longevity—it’s about maintaining our cognitive function and quality of life. Our findings show you can do both.”

REFERENCES

Optimal cardiovascular health among people with Type 2 diabetes may offset dementia risk. American Heart Association. Published November 3, 2025. Accessed November 6, 2025. https://newsroom.heart.org/news/optimal-cardiovascular-health-among-people-with-type-2-diabetes-may-offset-dementia-risk?preview=5030&preview_mode=True