Cognitive Impairment Linked to Cardiovascular Events in Type 2 Diabetes


Cognitive impairment is linked to the risk for major cardiovascular events like a heart attack or stroke — and may indicate the need for stepped-up efforts to prevent these events, according to a new study published in the Journal of Clinical Endocrinology & Metabolism.

Researchers have long known that there are links between type 2 diabetes, cardiovascular disease, and cognitive impairment — but new research is continually shedding light on how these conditions are related. Studies have shown that older people with type 2 diabetes are more likely to experience cognitive decline than those without diabetes, and that decline may begin earlier in life. Even people with prediabetes (elevated blood glucose that doesn’t meet the threshold for diabetes) may have an elevated risk for cognitive decline in middle age to older age. Studies have also shown that people with cardiovascular risk factors may be more likely to experience cognitive decline, with these factors linked more strongly to cognitive decline in women than in men. Even in younger adults, cardiovascular risk factors may predict cognitive decline later in life. Luckily, there are steps people with diabetes can take that may reduce the risk for cognitive decline, including optimizing blood glucose control and following a healthy diet.

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For the latest study, researchers looked at the results of cognitive assessments in 8,772 adults with diabetes from 24 countries. Participants completed two different types of assessments, and these results were combined and standardized based on the country where they lived — to account for any potential natural differences in cognitive performance based on geographic location. Then, the researchers analyzed the results and compared them with participants’ cardiovascular outcomes throughout the study period, as noted in an article on the study at MedPage Today.

Link found between cognitive impairment, risk of cardiovascular events

When the cognitive assessments were given, 905 participants (10.3%) were found to have substantial cognitive impairment. During an average follow-up period of about five years, these participants were 30% more likely to experience a heart attack, and 60% more likely to either experience a stroke or die. For participants who were found to have cognitive impairment based on the results of both tests — instead of just at least one — the risk for a heart attack was 61% higher than in participants without cognitive impairment, and the risk for either a stroke or death was 85% higher.

The researchers emphasized that this increased risk for major cardiovascular events was found even after adjusting for traditional cardiovascular risk factors like age, sex, education level, and any prior stroke or transient ischemic attack (TIA, a brief interruption of blood flow to the brain also known as a “ministroke”).

“Our study found low scores on cognitive tests predicted heart disease in people with diabetes and other heart risk factors,” said study author Hertzel C. Gerstein, MD, a professor of medicine at McMaster University in Hamilton, Canada, in a press release on the study. “Although the explanation for this remains unclear, proven heart medications should be offered to these patients to reduce their future risk of a heart attack or stroke.”

Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Seven Signs of an Unhealthy Heart.”

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