A new paper on ageing, authored by Dr Wamil and the team, has been published in the journal Nature Ageing (Copy)

Diabetes, obesity and CV disease can worsen and speed up neurodegenerative processes, even when genetic risk is lower. Vascular and metabolic screening, along with early intervention, should be part of dementia risk management.

Alzheimer’s disease and Parkinson’s disease aren’t “one single illness”. This study used long-term NHS-style electronic health records (EHRs) from large UK datasets to enable an AI model to group people into distinct subtypes of Alzheimer’s and Parkinson’s based on the number of years of health data before diagnosis (including diagnoses and medications). It then checked whether those groups had different outcomes and different genetic patterns.

Big finding: the model repeatedly found five subtypes for each disease, and two themes kept showing up in both Alzheimer’s and Parkinson’s:

1) a vascular (blood pressure/vascular burden) pattern

2) a metabolic–inflammatory (diabetes/obesity/kidney disease) pattern

The “diabetes + cardiometabolic” story:

One subtype in both Alzheimer’s and Parkinson’s stood out as metabolic–inflammatory. People in this group had very high rates of:

1) pre-existing diabetes

2) obesity

3) kidney disease

Despite having lower genetic risk scores for Alzheimer’s (so, not strongly “genetically driven”), this metabolic group had more aggressive disease trajectories, including earlier symptoms and higher mortality.

1. Diabetes can disrupt insulin signalling in the brain, which may contribute to amyloid build-up and neuronal damage.
   

2. Obesity-related inflammation may accelerate neurodegenerative processes.
   

3. Proactive metabolic screening and intervention should be central to dementia/neurodegeneration risk management.
   

The “heart and vessels” story (why cardiovascular prevention is brain prevention)

Another shared theme was a vascular-associated subtype (high burden of hypertension and vascular disease patterns). In Alzheimer’s, this aligns with “mixed dementia”—where vascular damage can amplify Alzheimer's pathology.

Cardiovascular health can modify neurodegenerative trajectories, even in people who carry genetic susceptibility.