Avoiding three things during middle age is linked to 13 more years without dementia
· Medical Xpressedited by Lisa Lock, reviewed by Alexander Pol
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Having normal blood pressure, no diabetes and not smoking between ages 45 and 65 is associated with nearly 13 additional years of dementia-free life, on average, a new study shows. Led by NYU Langone Health researchers, the work also found that, no matter how many risk factors they had, women lived longer without dementia than men and that white study participants had more dementia-free years than Black participants.
Published online Aug. 5 in Neurology Open Access, the study results underscore the dual impact of the identified midlife risk factors, whose presence was linked to both accelerated dementia onset and shorter overall dementia-free life spans.
"Our findings argue that people need to actively avert these factors in midlife as a strategy for preserving brain health for more than a decade," said study senior investigator Josef Coresh, M.D., Ph.D., founding director of the Optimal Aging Institute, NYU Langone. "Discovering new ways to delay dementia is crucial, with 42% of Americans at risk for developing the condition at any time after age 55." Coresh is also the Terry and Mel Karmazin Professor in the Department of Population Health at NYU Langone.
For the new study, the researchers analyzed data from the community-based Atherosclerosis Risk in Communities (ARIC) Study, which started in 1986 and followed participants over decades into late life, measuring midlife vascular risk factors and dementia.
The current study looked at 12,409 people with an average age of 56 who were free of dementia. Participants were assessed for three risk factors: high blood pressure, diabetes and smoking. They were then followed for an average of 26 years. During that time, 3,008 developed dementia and 5,238 died without developing dementia. Those who had no risk factors lived without developing dementia nearly 13 years longer than people with all three risk factors (30 years total after the study's start versus 17 years).
The team also sought to determine how cardiovascular risk factors in midlife influenced dementia-free survival across demographics. Women with all three risk factors lived an average of 18.1 years from the start of tracking without developing dementia, compared with 16.6 years for male study participants. White participants with all three risk factors lived an average of 19.6 years without developing dementia, compared with 16 years for Black participants.
"These results suggest that vascular risk reduction may benefit all groups, but that certain populations, such as Black adults, may especially benefit from targeted prevention efforts," Coresh added. "Hopefully, these results will encourage people to stop smoking and watch their vascular health closely from age 45 onward."
Importantly, the study was not designed to prove that avoiding these vascular risk factors caused the observed delay in dementia—only that they were associated with each other. Another limitation of the study was that risk factors were measured only once, so changes over time were not captured.
More information
Midlife vascular risk burden and dementia-free survival years: The Atherosclerosis Risk in Communities Neurocognitive Study, Neurology Open Access (2026).
Key medical concepts
DementiaDiabetesHigh Blood PressureTobacco Smoking
Clinical categories
NeurologyHealthy agingCommon illnesses & PreventionPreventive medicineCardiology Provided by NYU Langone Health Who's behind this story?
Lisa Lock
BA art history, MA material culture. Former museum editor, paramedic, and transplant coordinator. Editing for Science X since 2021. Full profile →
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PhD nano-engineering from Delft University. Published researcher and journal reviewer. Brings scientific insight to content standards. Full profile →
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