Diabetes and prediabetes are both linked to a gap between brain age and real age, according to a recent study in Diabetes Care.
Diabetes, Prediabetes Linked to Older Brain Age / jolygon – stock.adobe.com
The study found that healthy habits such as not smoking, moderating alcohol consumption, and engaging in regular physical activity can help reduce this gap, potentially preserving brain health.
The Connection Between Diabetes, Prediabetes, and Brain Aging
Diabetes has long been recognized as a risk factor for dementia. However, the impact of prediabetes on brain aging has not been extensively studied until now. The researchers sought to explore how prediabetes and diabetes affect brain aging and identify lifestyle factors that might slow this process.
Study Methods
The study involved 31,229 participants aged 40 to 70 from the UK Biobank, none of whom had dementia. During the initial assessment, participants underwent physical and medical evaluations at 22 centers and completed questionnaires about their lifestyle. Around 9 years later, brain MRI scans were conducted on participants, with some undergoing a second scan.
Brain Aging Analysis
A machine learning model based on 1,079 brain MRI phenotypes was used to estimate each participant’s brain age. The brain age gap (BAG) was calculated by subtracting chronological age from brain age.
Key Findings
At the start of the study, 43.3% of participants had prediabetes, and 3.7% had diabetes. The results showed that both conditions were linked to larger BAGs compared to those with normal blood glucose levels.
Participants with diabetes had an average BAG of 2.29 years, meaning their brain age was 2.29 years older than their real age. Those with prediabetes had a BAG of 0.50 years. Poorly controlled diabetes (HbA1c ≥8.0%) led to the highest BAG, at 4.18 years.
Gender and Cardiometabolic Risk Factors
The association between diabetes and higher BAG was stronger in men, with a BAG of 2.63 years compared to 1.76 years in women. This pattern was also observed in prediabetes, with men having a BAG of 0.75 years and women 0.27 years.
Participants with a higher burden of cardiometabolic risk factors had a BAG of 3.08 years for those with diabetes and 1.32 for those with prediabetes. Those with no cardiometabolic risk factors had a BAG of 1.96 years for diabetes and 0.24 for prediabetes.
Role of Healthy Lifestyle
A healthy lifestyle was found to significantly reduce the BAG in participants with diabetes. Those who did not smoke, drank minimally, and exercised regularly had a BAG of 0.78 years, compared to 2.46 years in those with a less optimal lifestyle.
While a healthy lifestyle slightly reduced BAG in people with prediabetes or normal glucose levels, the effect was not statistically significant.
Longitudinal Impact
Using data from participants who underwent two MRI brain scans, the study revealed that diabetes was associated with a 0.27-year increase in BAG annually. This suggests that diabetes not only influences brain age but also accelerates the aging process in the brain.
Implications and Future Directions
Given that prediabetes is a reversible condition, these findings offer an additional motivation for patients to improve their blood sugar control. Individuals with both diabetes and prediabetes should be targeted for lifestyle interventions aimed at enhancing brain health.
Conclusion
While the link between diabetes and dementia is well-known, this study illuminates the lesser-understood impact of prediabetes on brain aging. It underscores the importance of maintaining a healthy lifestyle as a preventive measure against accelerated cognitive decline.
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