Engaging in exercise—at double the current recommended levels—may help mitigate the brain-aging effects of type 2 diabetes. Research suggests that this form of diabetes can accelerate the brain’s biological aging by up to four years. However, physical activity and other positive lifestyle choices appear to help offset this impact.
Key Highlights:
- A recent study using MRI scans found that individuals with diabetes had brains that were biologically 2.3 years older than their chronological age.
- For those with poorly controlled diabetes, the biological aging effect on the brain extended to nearly four years.
- Adopting healthy habits, including regular exercise, and avoiding smoking or excessive drinking, could help counter these aging effects.
Type 2 Diabetes and Accelerated Brain Aging
Type 2 diabetes is widely recognized as a significant risk factor for cognitive decline, even doubling the chances of developing dementia according to some estimates. A recent study involving more than 31,000 participants between the ages of 40 and 70 has reinforced this link by showing how type 2 diabetes and prediabetes can lead to accelerated brain aging. However, the study also points to the potential of a healthy lifestyle—regular physical activity, avoiding smoking, and limiting alcohol—to help counteract this effect.
“Having an older-appearing brain for one’s chronological age can indicate deviation from the normal aging process and may constitute an early warning sign for dementia,” noted lead author Abigail Dove, a researcher with the Karolinska Institute’s Aging Research Center in Sweden. “On the positive side, it seems that people with diabetes may be able to influence their brain health through healthy living.”
Elevated Blood Sugar and Its Effect on Brain Age
The researchers examined medical records from the UK Biobank, including cardiometabolic risk factors such as obesity, hypertension, and cholesterol, as well as lifestyle factors like smoking, drinking, and exercise. Among the 31,000 adults studied, 53 percent had normal blood glucose, 43 percent were prediabetic, and 4 percent had type 2 diabetes. Using a machine learning model, they assessed each participant’s brain age relative to their chronological age.
The findings, published in Diabetes Care, revealed that those with type 2 diabetes had brains that appeared biologically 2.3 years older than their chronological age. Individuals with prediabetes showed a milder effect, with brain aging accelerated by about four months. More concerning was the impact on people with poorly controlled diabetes, whose brains appeared over four years older than their chronological age. In a follow-up subset of 2,400 patients who underwent two MRI scans over 11 years, researchers observed a gradual increase in brain aging for those with diabetes, at just over three months per year.
“This study shows that even slightly elevated glucose levels—consistent with prediabetes—can affect the brain and cause it to age more rapidly,” said Susan Elizabeth Spratt, MD, a professor of medicine specializing in endocrinology, metabolism, and nutrition at Duke University. Although not involved in the study, Dr. Spratt emphasized the importance of managing blood sugar levels to prevent cognitive effects.
Insights from Magnetic Resonance Imaging
Using MRI technology, scientists analyzed various brain structures, including brain volume, cortical thickness (also known as gray matter), and the condition of white matter (nerve fiber networks). These detailed images offer valuable insights into how diabetes may contribute to brain aging. However, as Ajaykumar D. Rao, MD, chief of endocrinology, diabetes, and metabolism at the Lewis Katz School of Medicine at Temple University, pointed out, MRIs may not be practical for regular cognitive assessments.
“We can’t be subjecting everyone with prediabetes and diabetes to multiple MRIs—they may not be clinically meaningful,” explained Dr. Rao, who was also not part of the research team. Instead, he recommended that individuals with diabetes consult with their primary care doctors about the possibility of neurocognitive testing.
Role of Healthy Lifestyle Choices
Encouragingly, the study found that certain lifestyle habits could help mitigate brain aging in people with diabetes. “The good news is that adopting a healthy lifestyle—not smoking, not drinking heavily [defined as more than 14 alcoholic drinks per week], and exercising at least twice as much as current recommendations—protects your brain from aging,” noted Dr. Spratt. Current guidelines from the Centers for Disease Control and Prevention recommend 150 minutes of moderate-intensity or 75 minutes of vigorous physical activity per week, but the study suggests that doubling this may offer additional protection.
Thomas Vidic, MD, a clinical professor of neurology at Indiana University School of Medicine and a practicing physician at the Elkhart Clinic, echoed the importance of lifestyle factors. According to him, the study’s results align with existing knowledge on how diabetes can lead to vascular disease and inflammation, which can reduce blood supply to the brain and impact its tissue. In contrast, regular physical activity promotes healthy blood flow to the brain, counteracting these effects. Dr. Vidic further emphasized that both smoking and excessive alcohol consumption can harm brain cells, whereas avoiding them can provide a protective effect.
“Brain health is a lifelong process, and we need to take care of all aspects of brain health throughout our lifetime,” said Dr. Vidic, who is also a fellow of the American Academy of Neurology. “It’s not one of those things that you turn 65 and say, ‘I need to get started on this.’”
Implications for Future Health Strategies
The findings underscore a critical need for awareness around brain health and the long-term impacts of type 2 diabetes. While diabetes may accelerate aging in the brain, adopting healthier habits offers a promising path for reducing this risk. Healthcare providers may need to stress the importance of lifestyle changes for their patients with diabetes, as these choices could directly influence brain health.
As researchers continue to uncover links between lifestyle, diabetes, and cognitive health, the role of preventative strategies becomes clearer. With exercise, dietary choices, and healthy behaviors, people with diabetes have the opportunity to protect their brains and potentially slow the aging process.
In summary, while type 2 diabetes is linked with accelerated brain aging, the adoption of positive lifestyle habits could play a critical role in preserving cognitive function and promoting overall brain health. For individuals with diabetes, making these changes may be one of the most effective ways to safeguard against early cognitive decline.
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