Diabetes and Dementia: Is there a relationship and should you be concerned?
It’s no secret to most of us living with diabetes that we run a higher risk for related health complications, such as cardiovascular disease, nerve damage, vision problems and kidney disease. Recently, doctors and scientists are adding a new concern to the list - an increased risk of dementia.
While more research still needs to be done in order to determine the link between diabetes and dementia and the exact relationship causing the increased risk, researchers tend to be on the same page when it comes to agreeing that there is a connection between the two conditions.
What is Dementia?
Dementia is the result of a degeneration of neurons in the brain or disruptions in the body’s systems that affect how brain cells function. Dementia is not actually one disease, but a group of conditions characterized by the impairment of brain functions, such as memory, judgement, cognitive ability, language skills, and reasoning. Some people suffering from dementia also experience uncontrollable emotions and distinct changes in their personalities.
There are more than 3 million reported cases of dementia in the United States each year. They range in severity depending on how long a person has had the condition. Dementia increases gradually over time. In the early stages, a person might only experience mild bouts of forgetfulness or fleeting moments of confusion. However, as the condition progresses, it’s quite possible that the individual will not be able to perform the basic acts of living and will require daily and long-term care.
Dementia is more common as people grow older. In fact, according to the National Institute on Aging (a division of the National Institutes of Health), about one-third of all adults ages 85 and older have some form of dementia. Then again, many people live well into their 90s without experiencing the slightest signs of the condition.
Diabetes and Dementia
The relationship between diabetes and dementia is not entirely understood, however, research has shown a correlation between diabetes and dementia conditions, including Alzheimer’s Disease. In fact, studies show that having Type 2 diabetes can roughly double the risk of dementia and may cause it develop years earlier.
As you might guess, the relationship between diabetes and dementia is believed to be, at least in part, related to blood sugar levels. In a 2021 post by the American Heart Association, Dr. Shannon Macauley, Assistant Professor of Gerontology and Geriatric Medicine at Wake Forest School of Medicine, points out why this might be the case.
She says, “Glucose is unbelievably important for the brain. Though it makes up just 2% of the body’s weight, the brain uses 20% - 30% of circulating blood glucose.” In other words, the brain is a big user of your blood sugar supply and that’s why fluctuations, both high and low, might cause a problem.
Here’s a quick rundown.
Hyperglycemia (High Blood Sugar) and Dementia
Studies, including those conducted by the National Institutes of Health (NIH), point to a connection between high blood sugar and a substantial increase in a protein called beta-amyloid, which happens to be toxic to cells in the brain. Even more telling is the fact that concentrations or “clumps” of beta-amyloid protein have also been shown to build up in the brains of individuals diagnosed with Alzheimer’s Disease. Therefore, it only makes sense that prolonged periods of high blood sugar in individuals with diabetes (particularly Type 2) can contribute to the build-up of these cell-destroying proteins, contributing to the risk of developing Alzheimer’s Disease.
Hypoglycemia (Low Blood Sugar) and Dementia
When blood glucose levels fall too low, it robs the brain of the energy it needs to function properly. Remember, the brain uses up to 30% of your circulating blood glucose. If levels drop substantially, that means your brain is not getting the glucose it needs to perform ordinary bodily tasks. Additionally, low blood sugar is known to damage the hippocampus region of the brain, the one that serves as the brain’s memory center. Obviously, any disruption to the brain’s ability to regulate memories might contribute to the development of dementia.
Additional Risk Factors for Dementia Related to Diabetes
Many individuals with Type 2 diabetes present other health complications that may also increase the risk of dementia, including Alzheimer’s Disease. These include:
– Lack of Physical Activity
– Hypertension (high blood pressure)
The bottom line is heart health compromised by these key morbidities very well may play a role in contributing to the onset of dementia. There are a lot of blood vessels in the brain and good heart health, built around a diabetes-friendly diet, proper weight control, and an adequate amount of activity equates to good blood vessel health. Essentially, when you take care of your heart, you are also taking care of your brain.
How Can You Prevent Dementia?
While there are no guarantees when it comes to dementia, particularly as we as human beings continue to live longer, there is one thing you can do as someone living with diabetes to minimize your risk.
You guessed it! Maintain proper control over your blood sugar levels. If dementia is related to both high and low blood sugar, it makes maintaining balanced levels all the more critical. That means testing your blood sugar regularly and following your doctor-prescribed medication plan, including insulin treatments by syringe or insulin pen.
If you are currently using a glucose meter and test strips to measure your blood sugar and are having difficulty maintaining blood glucose levels in the target range, you may want to talk with your doctor about continuous glucose monitoring devices, such as the Dexcom G6 and FreeStyle Libre 2. They’ve been known to aid in blood sugar control for individuals who have problems with highly fluctuating blood sugar levels.
Another thing you can do to help lower your risk of developing dementia is to keep your brain active. Socializing and communicating with others, playing games, solving puzzles, learning to play music, challenging yourself with other new hobbies can all play a role in keeping your cognitive energy going and your brain working at its best.
The precise relationship between diabetes and dementia is still being studied. That being said, there is plenty of evidence that a connection exists. The good news is that if you continue to do the things you do every day to minimize the risk of other diabetes-related complications, such as heart disease and stroke, you’re also doing right by your brain. Essentially, making sure your diabetes is properly managed by following your doctor-prescribed treatment plan is the best thing you can do to stay healthy, happy and at the top of your game.
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