Welcome to Paging Dr. Gupta. Thank you so much for joining us. We are really trying to be your source for answers to whatever health questions you've been mulling over. Feel free to send those in to us. This is the show where we take those questions, really dig into the science and hopefully the stories behind them. Kyra's back with us. Who do we have first?

Hey Sanjay. So first up today, we've got a question from Alan in Ottawa, Canada, who wrote in asking if having type 2 diabetes accelerates cognitive decline if you're over the age of 70.

Alan, I am really glad you asked about this, because so many people in both Canada and the United States have type 2 diabetes. In fact, around 11% of the general population lives with diabetes, and the numbers for those over the age of 65 jump up close to 30%. Keep that in mind when we give you the answer right after the break.

'Alright, so does having type 2 diabetes affect cognitive decline in older adults? Well, the short answer, unfortunately, is yes. Studies find that diabetes can increase the odds of developing cognitive decline up to two times. A 2021 JAMA study following about 10,000 men and women found that those who had diabetes at age 70 had a higher likelihood of developing cognitive decline. So, you know, older adults with diabetes do have higher instances of dementia overall, Alzheimer's disease, and also something known as vascular dementia. And it has also been shown that the risk of cognitive decline in dementia is higher for those who develop diabetes at a younger age. So the earlier the age when you develop diabetes, the more likely you are to have cognitive decline again after age 70. Now, we don't know exactly why this is, but the connection appears to be pretty strong. So much so that some people have started calling Alzheimer's type 3 diabetes. Now that might be a bit hyperbolic, but I think there's no question that we know diabetes raises the risk of heart disease and stroke, which hurt heart and blood vessels, damaged blood vessels in the brain, could contribute to cognitive decline. We also know that the brain is dependent on many different chemicals, which can become imbalanced when insulin is not working as it should. Some of those changes could trigger cognitive decline, high blood sugar all by itself is pro-inflammatory that could damage brain cells and cause dementia to develop. But all this to say that there's clearly a connection between lifestyle and dementia. In fact, if you look at some of the latest studies, probably around 40% of dementia cases are preventable through lifestyle changes -- healthy balanced diet, physical activity, exercising your brain, social activity, and yes, keeping your blood sugar in check. There was another recent study called the Poynter Study, around 2,000 participants from across the United States, people who were between the ages of 60 and 79 and were cognitively healthy, okay, so they did not have problems, but they were leading sedentary lifestyles and had a higher risk of dementia due to health issues like pre-diabetes or borderline high blood pressure. And what they did in these two groups is one was given sort of a structured lifestyle intervention program, and the other was given guidance, but they were told to sort of do it on their own. All of it was geared towards healthy behaviors. Things like 30 minutes of cardio a day plus several days of weight training, a Mediterranean DASH diet, which is basically the Mediterranean diet with even more salt restrictions, certain brain training exercises, social activities, and health monitoring. Both groups that focused on these lifestyle changes did see an improvement in cognitive function. So that was really encouraging. There was other studies that have shown people who had even been given the diagnosis of cognitive impairment or early Alzheimer's disease also saw an improvement. Not only were they able to slow or stall the progression of the disease, in some cases they were able to reverse it with lifestyle changes alone. So there's this connection between high blood sugar, diabetes and cognitive impairment. But I think the evidence is becoming increasingly clear that there's a lot that you can do about it. Hope that helps, Alan. I'll be back to answer another one of your questions right after the break.

All right, all sorts of pagers going off. Kyra, who's next?

Okay, next up we've got Cal. Now, he's wondering, can learning a new language or even picking up a new instrument, can that actually help slow down cognitive decline? Or what kind of impact does that have?

'So just as keeping your body active is important, and we know it's really important, not just for your physical health, but your brain health as well, we also know that learning a new language or learning to play an instrument can have a really significant beneficial impact on cognitive decline. I love this question. I love the topic. It is true that just moderate brisk activity, physical activity, is probably the most evidence-based way to improve your overall brain health. But when it comes to doing other things, learning new skills, taking on new hobbies, the key word here is new. A lot of people focus on things like crossword puzzles, which can be really helpful for overall brain-health, but mostly what crossword-puzzles do is make you really good at crossword puzzles. What you want to do is something new! Learning a new language is kind of like a form of developing cognitive reserve, like a demanding career of some sort that's going to strengthen and organize your brain circuits, helping to fight off the initial symptoms of dementia until later in life. I really loved this one study when it came to instruments. There was a study of twins where one twin had developed dementia, the other didn't. And what they found after controlling for education and physical activity, that playing a musical instrument was significantly associated with lower likelihood of dementia and cognitive impairment. So, you know, genetically identical individuals, the only big difference was that one played an instrument. Taking that a step further, there was a study that found professional musicians who began training before age seven actually had reliably thicker areas of certain parts of the brain, such as the anterior corpus callosum, which is the very front of the brain that sort of connects the two hemispheres. Even learning an instrument later in life, was associated with improved attention, improved thinking skills, and overall better mental health.

'So, Shukriya, merci, gracias for your question. Thank you very much. That's all the time we have for today. Thanks to everyone who sent in questions. I'm inspired by your curiosity. I love reading these questions, I love hearing your stories and I love your voices. That is what makes this show so special. So keep the questions coming. If there's something health related you've been wondering about send it to us, we might try and answer it next week! Record a voice memo email it to AskSanjay@cnn.com or give us a call, 470-396-0832, and leave a message. Thanks so much for listening. I'll be back next Tuesday.