If you have diabetes, you’re probably aware that the disease can cause damage to your eyes, nerves, kidneys and heart. One important part of your body that doesn’t get as much attention is your brain and cognitive health.
Having diabetes significantly increases your risk of developing memory problems, dementia, and Alzheimer’s disease later in life. The disease affects blood vessels and can restrict or block blood flow throughout your body and in the brain, especially when your blood sugar is poorly controlled. Research suggests that when diabetes develops in midlife, the reduced blood flow to the brain results in a smaller brain volume, and sometimes a type of dementia known as vascular dementia, later in life. People with diabetes are also more likely to experience changes in their brain that are associated with Alzheimer’s disease.
Who is at greatest risk?
Cognitive decline, dementia and Alzheimer’s disease are more likely to affect people with diabetes after the age of 65. However, the health of your brain may begin to decline much earlier, and it appears to be related to blood sugar levels. People with higher A1C levels, and those who have had diabetes for a longer period tend to perform worse on cognitive testing than those with lower A1C levels, or shorter duration of the disease.
Prevention is important
Because there is no cure for chronic neurodegenerative diseases, prevention is key to maintaining brain health and cognitive function. If you have diabetes, it’s important to monitor your blood sugar and work to keep it within a healthy range. Other effective strategies to maintain cognitive function include living a healthy lifestyle, exercising regularly, establishing a strong social support network, and eating a healthy diet. Scientists have identified certain dietary patterns, and specific foods and nutrients that have been shown to help maintain brain health.
- The MIND Diet is a hybrid of the Mediterranean and DASH diets. It focuses on 10 brain-healthy foods, and 5 unhealthy foods to limit. The brain-healthy foods are largely all nutrient and antioxidant-rich, and contain compounds that have been shown to reduce inflammation throughout the body and in the brain. Research results on the diet indicate that following it closely can reduce the risk of Alzheimer’s disease by 53%, but even those who follow it less strictly can still have a 35% reduction in risk. The foods to eat more of include:
- All vegetables
- Leafy green vegetables in particular
- Berries, especially blueberries
- Nuts
- Beans/legumes
- Whole grains
- Fish
- Poultry
- Olive oil
- Wine
Foods to limit include: fried or fast food; red meats; cheeses; butter and stick margarine; sweets/pastries
- Vitamins and antioxidants available from certain foods and in supplements can be effective in reducing inflammation in the brain, slowing cognitive decline, and minimizing brain atrophy in older adults. They include:
- Omega-3 fish oil supplements
- Flavanols especially from cocoa or cocoa powder supplements
- Carotenoid compounds, especially beta-carotene and lutein from orange and leafy green vegetables, and astaxanthin from salmon or a supplement. Low levels of these compounds are associated with worse cognitive function
- Vitamin D – low vitamin D levels in women ages 60-70 are associated with cognitive dysfunction a decade later.
When taking a supplement for additional benefits, make sure it’s a high-quality supplement that can be well-absorbed, with proven bioavailability. Beta-carotene should be obtained from foods only, not from a supplement.
- When processed meats like bacon, sausages or hot dogs are cooked at a high temperature, they form Advanced Glycation End-Products (AGEs). These are harmful products that can accumulate in the body and accelerate aging and inflammation. Higher levels of circulating AGEs are linked to faster memory decline and Alzheimer’s. It’s important to limit processed meats, and if you do eat them, try to cook them at a lower temperature for a shorter amount of time.
References
Bartali B, Devore E, Grodstein F, Kang JH. Plasma vitamin D levels and cognitive function in aging women: the nurses’ health study. The journal of nutrition, health & aging. 2014 Apr 1;18(4):400-6.
Roberts RO, Knopman DS, Przybelski SA, Mielke MM, Kantarci K, Preboske GM, Senjem ML, Pankratz VS, Geda YE, Boeve BF, Ivnik RJ. Association of type 2 diabetes with brain atrophy and cognitive impairment. Neurology. 2014 Apr 1;82(13):1132-41.
Tuligenga RH, Dugravot A, Tabák AG, Elbaz A, Brunner EJ, Kivimäki M, Singh-Manoux A. Midlife type 2 diabetes and poor glycaemic control as risk factors for cognitive decline in early old age: a post-hoc analysis of the Whitehall II cohort study. The lancet Diabetes & endocrinology. 2014 Mar 31;2(3):228-35.
Wennberg AM, Hagen CE, Gottesman RF, Zipunnikov V, Kaufmann CN, Albert MS, Rebok GW, Kasper JD, Spira AP. Longitudinal association between diabetes and cognitive decline: The National Health and Aging Trends Study. Archives of gerontology and geriatrics. 2017 Oct 31;72:39-44.
West RK, Moshier E, Lubitz I, Schmeidler J, Godbold J, Cai W, Uribarri J, Vlassara H, Silverman JM, Beeri MS. Dietary advanced glycation end products are associated with decline in memory in young elderly. Mechanisms of ageing and development. 2014 Sep 30;140:10-2.