Dementia in type 2 diabetes: risk factors, disease processes and opportunities for prevention across the lifespan – published 13/07/2026

Jan F. de Leijer, Geert Jan Biessels, Frank L. J. Visseren, Thomas T. van Sloten

The number of older people with type 2 diabetes is increasing. Prevention of diabetes-related comorbidities in later life, notably dementia, is therefore becoming increasingly important. In this issue, de Leijer et al (https://doi.org/10.1007/s00125-026-06795-2) argue that the higher risk of dementia among individuals with diabetes may be best understood through a probabilistic model that considers the context in which type 2 diabetes develops and the involvement of multiple dementia-related pathologies. Their review explains how, within this model, type 2 diabetes may alter both the probability of dementia-related pathologies occurring and their downstream consequences. They emphasise that opportunities for prevention evolve across the lifespan and likely require a holistic approach aimed at reducing cumulative exposure to multiple dementia risk factors. This approach may include multi-domain cardiovascular risk management and glucose-lowering therapies with effects beyond glycaemic management, notably GLP-1 receptor agonists, multihormone receptor modulators and SGLT2 inhibitors. The figure from this review is available as a downloadable slide.