Poor metabolic health is associated with memory and thinking problems

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People with poor metabolic health are more likely to have memory and thinking problems and poorer brain health, according to a new study from researchers at Oxford Population Health. The study was published in Diabetes Care and is the largest study to date on metabolic and brain health.

Poor metabolic health, also known as “metabolic syndrome,” is defined as having three or more of the following: large waist circumference, high triglycerides, high blood pressure, high blood sugar, and lower levels of high-density lipoprotein (HDL) cholesterol, also called ‘good’ cholesterol. Worldwide, one in four adults lives with metabolic syndrome.

Previous studies have shown that poor metabolic health could increase the risk of developing dementia, but it was unclear whether this is linked to poorer brain health, even in people who do not have dementia. Maintaining both brain structure and cognitive skills is crucial for healthy aging, as the loss of both can negatively impact brain health and indicate progression toward dementia.

The researchers examined whether poor metabolic health affected brain volume and cognitive skills by analyzing results from 37,395 UK Biobank participants who did not have dementia; 7,945 of the participants were in poor metabolic health when they took part in the UK Biobank study.

The study found that poor metabolic health was linked to:

• Lower total brain volume and lower gray matter volume, which is responsible for processing information in the brain;
• Increased white matter hyperintensities, a marker of vascular brain damage previously associated with dementia;
• Memory problems, indicated by reduced hippocampal volume and poorer performance on cognitive tests of working memory (a type of short-term memory) and verbal declarative memory (the ability to remember and repeat information);
• Poorer performance on cognitive tests of processing speed (how quickly you process information), verbal and numerical reasoning (ability to understand and manipulate words and numbers), non-verbal reasoning (ability to understand information that is not presented as words or numbers presented, such as in images and diagrams), and tests of executive function (involved in planning and problem solving).

Danial Qureshi, PhD candidate at Oxford Population Health and lead author of the study, said: ‘Our research results show that poor metabolic health is associated with a reduction in brain volume and poorer cognitive performance, and this may contribute to the future development of dementia. It is estimated that up to 40% of dementia cases can be prevented by changes in diet and lifestyle. Therefore, maintaining metabolic health could be critical to reducing the risk of dementia and related brain disorders.”

Dr. Thomas Littlejohns, senior epidemiologist at Oxford Population Health and senior author of the study, said: ‘Poorer metabolic health is thought to play an important role in the future risk of developing dementia. Interestingly, our findings show that it is also associated with poorer brain health, even in individuals without dementia. These findings were consistent across different age groups, including those in their fifties, sixties and seventies. The next step is to confirm whether better prevention, treatment and management of metabolic disorders leads to better brain health, both in midlife and later life.”

Madeleine Walpert, Research Fellow at Dementia UK, said: ‘This large study highlights the importance of recognizing conditions that can increase the risk of dementia and show similar symptoms to dementia. The findings show that metabolic syndrome reduces gray matter volume, increases vascular brain damage and affects cognition in domains such as memory and processing speed – paralleling some hallmark symptoms of dementia.

This evidence reinforces the need to understand how conditions interact and manifest with overlapping conditions, especially as 9 in 10 people with dementia also live with another long-term health condition. It is important to treat and care for people holistically, addressing not only individual conditions, but also the interplay between co-existing conditions and their combined impact on overall health and wellbeing.”

The researchers used data from the UK Biobank, which consists of more than half a million women and men who took part in the study between 2006 and 2010, aged 40 to 69. As of 2014, more than 50,000 participants underwent additional assessments, which included brain imaging and completing a battery of cognitive tests. By combining this data with other information, scientists can provide unprecedented insights into how age-related diseases develop.

Reference: Qureshi D, Topiwala A, Al Abid SU, Allen NE, Kuźma E, Littlejohns TJ. Association of metabolic syndrome with neuroimaging and cognitive outcomes in the UK Biobank. Diabetes Care. 2024:dc240537. doi: 10.2337/dc24-0537

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