Type 2 diabetes mellitus is associated with accelerated cognitive decline in the elderly. This includes increased risk for mild cognitive impairment (often seen as short-term memory loss that is either subjective or confirmed by rigorous memory tests) as well as dementia (moderate to severe short-term memory loss that causes a lack of independence).

A recent study indicated that type 2 diabetes also accelerated the rate at which those with mild cognitive impairment progress to a diagnosis of dementia. The dementia may be either caused by Alzheimer’s disease, vascular disease or both.

Individuals with both mild cognitive impairment and diabetes are at greater risk of becoming more seriously and cognitively impaired over time. As is true of most studies, the studied population consisted of mostly whites of European decent and the design of the study was retrospective or epidemiological. As there are nearly 6 million cases of type 2 diabetes in the U.S., it is important for those at risk to remain proactive as managing the risk of developing type 2 may also reduce the risk of becoming demented.

Attend to risk factors for type 2 diabetes. Risk factors include a family history of diabetes; being older than 45; hypertension; metabolic syndrome; “good” cholesterol less than 35 mg/dl and/or triglycerides greater than 250 mg/dl; history of gestational diabetes; polycystic ovary syndrome; inactive (exercise less than three times per week); and ethnicity (black, Hispanic/Latino, Native American, or Asian).

If you have any of these risk factors, monitor blood sugars. But don’t also forget to monitor memory. Those with changes in memory who develop type 2 diabetes are at great risk of cognitive decline.

But don’t wait for a diagnosis. If you have these risk factors there are many life style choices you can make now. First, get moving. Increase your aerobic exercise to the point where you are exercising 5-6 days a week for at least 30 minutes. This is probably the most important element for maintaining cardiovascular and brain health. Second, eat well most of the time. Eat mostly fruits and vegetables with smaller portions of meats (no larger than a deck of cards).

Finally, don’t forget your memory. Use external memory aids liberally. If you have any concerns, get a memory evaluation. Stay ahead of changes in your blood sugars as well as your memory.