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By Meghan Holohan

Want to prevent cognitive decline and dementia in old age? Be healthy in middle age. 

A study in the Annals of Internal Medicine finds that people with pre-diabetes or diabetes when they’re in their 50s experience more cognitive decline than those with normal blood glucose levels. 

“People are very scared of dementia and very scared of cognitive decline, even more so than of a heart attack,” says Elizabeth Selvin, an author of the study and associate professor of epidemiology at Johns Hopkins Bloomberg School of Public Health. “If we do the things to prevent progression from pre-diabetes to diabetes … we can help stave off cognitive decline.”

Getting fit in midlife may help your brain in old age, a new study suggests.oliveromg / Today

To understand the role of diabetes in cognitive decline, the precursor to dementia, Selvin and her colleagues examined data from the Atherosclerosis Risk in Communities Study, a longitudinal study of 15,792 middle-aged adults beginning in 1987. 

The researchers noticed that people in their 70s who had diabetes at midlife had brains that were five years older than subjects with normal blood glucose levels. Having diabetes accelerated their mental decline; a 70-year-old exhibited the cognitive functioning of a 75-year-old. People with poorly controlled diabetes suffered worse, experiencing 19 percent more decline.

The takeaway? Preventing diabetes and controlling blood glucose can protect your brain, Selvin says.

Experts remain unsure why diabetes leads to cognitive problems. But the good news is that people can make lifestyle changes that will boost brain health:

  • Lose it. Losing as little as five to 10 percent of body weight can prevent diabetes, Selvin says.
  • Be active. “When people do large muscle group movement, exercising, walking or dancing or golf, it stimulates the production of an enzyme that is only released to uptake the glucose into the muscle,” says Leslie Bonci, director of sports nutrition at UPMC Center for Sports Nutrition, who was not involved in the study.
  • Watch your carbs. Try eating protein at breakfast and lunch; this makes people feel fuller, cutting down on snacking and swings in blood sugar levels. Bonci suggests that when looking at the plate, people divide it by percentages — 40 percent fruits and vegetables, 40 percent protein, and 20 percent starchy carbs, such as corn, pasta or potatoes. “It’s not about no carbs, but it is about being selective,” she says.
  • Load your plate the right way. It’s not only about subtracting. Adding can also help, Bonci says. Studies suggest that omega-3 fatty acids, found in fishes such as salmon, sardines and tuna, improve memory. Turmeric and vitamin B might both contribute to good brain health. 
  • Beware of binges. “Even trying to be more regular with distribution over the day with what one eats … is a good habit,” Bonci says.