[ggm]

Would people with metabolic syndrome ("pre type 2") also have this risk, or would fully evidenced type 2 be necessary?

An awful lot of people live semi continuously for years in a pre diabetic state. Not "I am not diabetic" and not "I have diabetes" -continually reminded by their medical advisors to cut down on their intake and drinking, exercise more and fix their sleep hygiene. "Or you'll have to go onto the drugs"

[rpkoven]

My thought is yes. There has to be neuronal death as the neuron becomes less sensitive to insulin and metabolize glucose.

[dtawfik1]

Pre-diabetes undoubtedly leads to impaired glucose metabolism in neuronal cells.