Choices people make regarding their health during their 50s can influence how well their brains function in later years. A recent study indicates that staying physically active and managing blood sugar levels in middle age may be linked to a slower decline in memory and cognitive skills.
Researchers at UT Health San Antonio examined adults who participated in long-term health projects in South Texas. Their findings also suggest that key heart health factors associated with brain aging may vary between Hispanic and non-Hispanic white individuals.
The study was published on July 23 in Alzheimer’s & Dementia: Behavior & Socioeconomics of Aging. The research involved scientists from the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases and The University of Texas Rio Grande Valley.
Scientists have increasingly explored the link between heart and brain health. The same blood vessels that deliver oxygen and nutrients throughout the body also support brain tissue, keeping it alive and functioning properly.
Damage to blood vessels caused by high blood pressure, elevated blood sugar, smoking, or other issues can develop gradually over many years. This slow deterioration may explain why poor cardiovascular health in middle age is associated with a higher risk of developing dementia later in life.
Alzheimer’s disease is the most common form of dementia. It progressively impairs memory and thinking, eventually making everyday tasks like managing finances, preparing meals, or recognizing loved ones much more difficult.
While there’s currently no guaranteed way to prevent Alzheimer’s, research suggests that a significant portion of dementia cases may be linked to modifiable factors such as physical inactivity and cardiovascular disease.
The study involved 402 individuals from San Antonio, with an average age of around 58. Slightly more than half identified as Hispanic, while the remaining participants were non-Hispanic white. Women made up nearly 59% of the group.
These individuals originally participated in the San Antonio Heart Study, a long-standing project investigating diabetes and heart disease. Some of them later joined the San Antonio Longitudinal Study of Aging, which monitored health and disability as participants aged.
Using these records, researchers asked whether measurements of heart health during middle age could predict changes in cognitive abilities over time.
The team evaluated cardiovascular health based on seven well-known factors promoted by the American Heart Association: physical activity, smoking, diet, blood pressure, body weight, cholesterol, and fasting blood glucose.
Fasting glucose refers to blood sugar levels after abstaining from food for approximately 8 to 12 hours. Elevated levels can indicate diabetes or issues controlling blood sugar, both of which can damage arteries and small blood vessels.
Cognitive function was assessed up to four times using the Mini-Mental State Examination, a brief test that evaluates memory, attention, orientation, language, and other basic mental skills.
When analyzing how scores changed over time, researchers found that physical activity was particularly important among Mexican American participants. Those who engaged in some form of exercise experienced a slower decline in cognitive function compared to sedentary individuals.
For non-Hispanic white participants, blood sugar control was more clearly linked to cognitive health. Maintaining fasting glucose at 126 mg/dL or lower was associated with a slower decline in mental performance.
These findings don’t imply that exercise is only beneficial for Hispanics or that blood sugar control only benefits white individuals. Both habits are universally important, and the study was exploring statistical patterns within a relatively small sample size.
Exercise can support cognitive health through multiple pathways, including improving cardiovascular fitness, enhancing insulin sensitivity, lowering blood pressure, and boosting blood flow to the brain.
Managing blood sugar levels may also protect the brain indirectly. Long-term high blood sugar can damage blood vessels, increase stroke risk, and harm the tiny vessels that supply critical areas involved in memory and cognition.
This research is especially meaningful because Hispanic older adults have historically been underrepresented in dementia studies, despite experiencing significant risks related to Alzheimer’s and high rates of diabetes and obesity in some communities.
Another strength of the study is that both Hispanic and non-Hispanic white participants came from similar geographic regions. This allows for better comparisons within similar social and environmental contexts.
The researchers controlled for variables such as age, sex, income, and education, and performed additional analyses to assess whether dropout over time may have affected the results.
Limitations include the sample size, which at 402 individuals is not large enough to definitively generalize ethnic differences to other areas. The authors recommend larger future studies.
It’s important to note that the study shows associations, not cause-and-effect relationships. People who exercise might differ from inactive individuals in many ways, and healthier blood sugar could reflect broader health behaviors and good medical care.
Nonetheless, these findings align with a broader body of evidence linking good cardiovascular health with brain health. They suggest that addressing risk factors during middle age might be more effective than waiting until cognitive symptoms appear.
The main takeaway isn’t that specific exercise routines or blood sugar targets will guarantee dementia prevention. Instead, it emphasizes the importance of adopting healthy habits and getting medical care in midlife to protect both heart and brain health.
Researchers are continuing their work through the San Antonio Heart and Mind Study, incorporating brain imaging and neurological assessments to better understand why some individuals maintain cognitive function longer and whether these pathways differ across populations.
The most encouraging aspect is that the key factors identified are modifiable and relevant to overall health. The primary uncertainty remains in whether these ethnic differences are biological, social, or simply due to the small sample size—so they shouldn’t yet influence medical advice solely based on ethnicity.
Source: UT Health San Antonio.







