A leading health expert, Dr Annette Bosworth, has identified what she considers to be a key early warning sign of dementia, detectable up to 15 years before a formal diagnosis. In a recent appearance on Steven Bartlett’s Diary Of A CEO, Dr Bosworth explored the relationship between insulin resistance and the onset of dementia.
Dr Bosworth, known as Dr Boz, is an internal medicine physician with over two decades of experience, specialising in reversing medical conditions through ketogenic lifestyle approaches. She shares her expertise via her YouTube channel ‘Dr Boz’ and is a bestselling author, including works such as ‘KetoCONTINUUM: Consistently Keto Diet for Life’.
She emphasises that the earliest changes leading to dementia are metabolic rather than cognitive and can be identified a decade or more before symptoms manifest clearly. Specifically, Dr Bosworth points to persistently high insulin levels and insulin resistance as initial indicators.
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These metabolic disturbances impair the brain’s ability to clear cellular waste and disrupt its energy supply well before any noticeable memory problems or confusion arise. The first cognitive difficulties, such as becoming disoriented while driving, often signify that the brain has been accumulating metabolic ‘debris’ over many years.
Dr Bosworth explains, “When patients report forgetfulness or getting lost during routine activities, it often reflects 15 years of accumulating waste in the brain. By this stage, the underlying process is well established.” She stresses the urgency of addressing these metabolic factors early to prevent further progression.
Supporting this view, research from the American Academy of Neurology indicates that dementia leaves detectable biological footprints at least 15 years prior to diagnosis. Studies focusing on midlife metabolic health and early declines in productivity reinforce the long-term impact of metabolic dysfunction on brain health.
While elevated insulin levels and resistance are not direct cognitive symptoms, they serve as significant warning signs for increased dementia risk. Health organisations, including the Alzheimer’s Society, advocate for managing blood glucose, maintaining a balanced diet, and staying physically active to reduce susceptibility to cognitive decline.
Individuals with type 2 diabetes or systemic insulin resistance face a heightened risk of cognitive impairment and Alzheimer’s disease - a link sometimes informally termed “type 3 diabetes”, though it is not a formal medical diagnosis.
In clinical practice, Dr Bosworth monitors early biological markers such as haemoglobin A1C levels above 5.5, sustained vitamin D deficiency, and the lack of natural morning ketones, rather than relying solely on cognitive tests.
According to sources like Medical News Today, recognising early metabolic and biochemical dysfunction allows for timely interventions before memory symptoms appear. Unlike conventional brain scans that detect plaques after damage, these metabolic indicators reveal underlying inflammation and energy deficits contributing to dementia development.
Addressing these early metabolic signs may offer a critical window to preserve brain health and delay or prevent the onset of dementia-related conditions.