Adopting a healthy lifestyle also wards off the risk of dementia in patients with type 2 diabetes, suggests a new study published in the journal Neurology.¹

In this prospective study, Wang et al examined the impact of a combination of seven healthy lifestyle factors on new-onset dementia in patients with type 2 diabetes. For this, data of 167,946 people, mean age 64.1 years, with and without diabetes was obtained from the UK Biobank cohort. About half of the study population was female (51.7%). None of them had dementia at the onset of the study. The follow-up duration was 12.3 years (median).

The seven healthy lifestyle factors included no current smoking, moderate alcohol consumption (up to 2 drinks daily for men and one drink daily for women), regular physical activity (minimum 2.5 hours of moderate exercise or 75 minutes of vigorous exercise per week), healthy diet, adequate sleep duration (7-9 hours), less sedentary behavior (watching TV for <4 hours daily) and frequent social contact (living with others, meeting friends or family at least once a month, taking part in social activities at least once in a week). Each factor was assigned a score of one and an overall score was calculated ranging from 0-7.

Out of the total study population examined, 4351 people developed dementia due to any cause during the follow-up. Just 9% of the study subjects adhered to all seven habits; 24% followed six habits, 30% followed five, 22% followed four, 11% followed three, while 4% of the people followed only zero to two of the healthy habits.

The risk of dementia was higher in the diabetic subjects compared to the normoglycemic individuals. However, no such risk was observed for those with prediabetes.

Results showed an inverse association between the risk of incident dementia and the healthy lifestyle score, which was independent of the antidiabetic medication and glycemic status. The risk of incident dementia was increased 4-folds among the low scoring non-diabetic participants i.e., those who observed just two or less of the seven healthy habits under study compared to those who scored 7 on the lifestyle scale with hazard ratios (HR) of 4.01 and 1.74, respectively. Among those with diabetes, the HR for participants with a lifestyle score of 7 versus 0-2 was 0.46. The risk of dementia decreased by 11% with every healthy habit followed. Diabetic patients with a score of 7 were at greater risk of developing dementia than the non-diabetic participants with a score of 7.

Lifestyle modification is an integral part of diabetes management as adjunct to pharmacological therapy. It is often the first line of management. While its beneficial impact on glycemic control and other cardiometabolic risk factors in patients with diabetes are well-established, prevention or reduction in the risk for dementia is an additional bonus of a healthy lifestyle as demonstrated in this study. Clinicians should therefore encourage their patients to adopt and faithfully adhere to healthy lifestyle habits.

Reference

1. Wang B, et al. Association of combined healthy lifestyle factors with incident dementia in patients with type 2 diabetes. Neurology. 2022 Sep 14:10.1212/WNL.0000000000201231. doi: 10.1212/WNL.0000000000201231.