Diabetes and Dementia: Spotlight on Multidomain Lifestyle Strategies.

Abstract

Diabetes mellitus is a major public health concern in older adults and has been directly associated with several neurologic outcomes, such as dementia and stroke.1,2 As such, investigating factors that might mitigate the diabetes-dementia relationship has become of particular interest. In this issue of Neurology ®, Wang et al.3 examined whether a combination of 7 healthy lifestyle factors (not smoking, moderate alcohol consumption, physical activity, healthy diet, adequate sleep duration, less sedentary behavior, and frequent social contact) could mitigate the risk of dementia related to type 2 diabetes. Their analysis used data from 167,946 dementia-free participants from the UK Biobank aged 60–73 years at baseline, and a healthy lifestyle score ranging from 0 to 7 was calculated by considering no current smoking, moderate alcohol consumption, physical activity, healthy diet, adequate sleep duration, less sedentary behavior, and frequent social contact (each given 1 score in case of compliance). As expected, diabetes at baseline was related to increased risk of dementia over a median follow-up of 12.3 years. Overall, healthier lifestyle scores had a dose-response relationship with lower dementia risk, irrespective of diabetes status, or glycemic control and medication in people with diabetes. However, this graded association between healthier lifestyle and lower dementia risk was significantly stronger in people with diabetes, suggesting that a healthier lifestyle may confer greater benefits in this group at risk for dementia.