A recent study entitled “Association of Combined Healthy Lifestyle Factors With Incident Dementia in Patients With Type 2 Diabetes” was published in September in the online issue of Neurology, the journal of the American Academy of Neurology.

Study author, Yingli Lu, MD, PhD, of Shanghai Jiao Tong University School of Medicine in China, and colleagues were determined to identify why some people living with the diagnosis of diabetes lead healthier lives and are less likely to develop dementia as they aged. “Our research shows that for people with type 2 diabetes, the risk of dementia may be greatly reduced by living a healthier lifestyle,” Dr. Lu stated. “Doctors and other medical professionals who treat people with diabetes should consider recommending lifestyle changes to their patients. Such changes may not only improve overall health, but also contribute to prevention or delayed onset of dementia in people with diabetes.”

To determine whether the increased risk of dementia among individuals with diabetes can be mitigated by a wide array of healthy lifestyle factors, the researchers conducted a prospective study using data they collected from the UK Biobank cohort. They then established a score that measured overall lifestyle activities, ranging from 0 to 7, with 1 point for each of the seven healthy lifestyle factors they focused on.

These seven factors included getting regular physical activity and reporting less sedentary behaviors, eating a healthy diet, not currently smoking, moderate alcohol consumption, adequate sleep duration of no fewer than 9 hours a night, and frequent social contact. Occurrence of dementia was determined using linked electronic health records, and Cox proportional hazard models were used to examine the associations between the healthy lifestyle score, diagnosis of diabetes, and the incidence of dementia.

The team included 167,946 participants aged 60 years and older who did not have a diagnosis of dementia at baseline (mean age 64.1 [SD 2.8] years, 51.7% female). Over the course of the median follow-up of period of 12.3 years, 4,351 developed all-cause dementia, and subjects with diabetes showed a higher risk of dementia than those without. When compared with counterparts without diabetes whose lifestyle score was 7, the hazard ratios (HRs) for dementia for those with diabetes who had a lifestyle score of 0 to 2 and 7 were 4.01 (95% CI, 3.06-5.25) and 1.74 (95% CI, 1.11-2.72), respectively. Within the group with diabetes, the HR for dementia was 0.46 (95% CI, 0.28-0.75) when comparing a lifestyle score of 7 versus 0 to 2.
 
The authors wrote, “This finding corresponded to a reduction in the 10-year absolute risk of dementia from 5.22% (95% CI, 3.94%-6.73%) to 1.72% (95% CI, 0.92%-2.97%),” and added, “The inverse association between healthy lifestyle score and dementia risk was independent of glycemic control and diabetes medication.”

“Type 2 diabetes is a worldwide epidemic that affects one in 10 adults, and having diabetes is known to increase a person’s risk of developing dementia,” stated Dr. Lu. “We investigated whether a broad combination of healthy lifestyle habits could offset that dementia risk and found that people with diabetes who incorporated seven healthy lifestyle habits into their lives had a lower risk of dementia than people with diabetes who did not lead healthy lives.”

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