Key Takeaway:
- Healthy midlife habits matter: Normal blood pressure, no Type 2 diabetes and not smoking may delay dementia by nearly 13 years.
- Early prevention counts: Managing cardiovascular health between ages 45 and 65 may lower the risk of cognitive decline.
- Heart and brain are linked: Experts recommend staying active, avoiding smoking and controlling blood pressure and diabetes to support long-term brain health.
Maintaining normal blood pressure, avoiding Type 2 diabetes, and not smoking between ages 45 and 65 may delay dementia by nearly 13 years, according to a long-term U.S. study published in Neurology.
Study links midlife heart health to longer brain health
Researchers from NYU Langone Health found that three modifiable cardiovascular risk factors in midlife strongly influence how long people live without dementia. The findings, published in the journal Neurology, are based on data from the Atherosclerosis Risk in Communities study, which has tracked participants since 1986.
The analysis included 12,409 adults with an average age of 56 who were free of dementia at enrollment. Researchers evaluated participants for high blood pressure, Type 2 diabetes, and smoking, then followed them for an average of 26 years.
During the study period, 3,008 participants developed dementia, while 5,238 died without receiving a dementia diagnosis.
People who entered the study without any of the three risk factors lived an average of 30.1 additional years free of dementia. Participants with one risk factor averaged 26.3 dementia-free years, those with two averaged 21 years, and those with all three averaged just over 17 years.
Researchers urge action between ages 45 and 65
The study concludes that controlling these risk factors during middle age could significantly extend the number of years people live without cognitive decline.
“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 Dr. Josef Coresh, senior investigator and director of the Optimal Aging Institute at NYU Langone Health.
Coresh said the results should encourage adults to stop smoking and closely monitor their cardiovascular health beginning around age 45.
Researchers also found demographic differences. Women generally lived longer without dementia than men regardless of the number of risk factors present. White participants also experienced more dementia-free years than Black participants, although the study did not identify the underlying reasons for those differences.
The authors said the three identified risks commonly emerge during midlife and may contribute to long-term changes associated with neurodegenerative disease, reinforcing the importance of early detection and treatment.
Experts say prevention remains a key strategy
The findings come as global dementia cases are projected to nearly triple to 153 million by 2050. Previous research suggests that nearly half of dementia cases worldwide could be prevented or delayed by addressing modifiable risk factors throughout life.
Dr. Jacqui Hanley, head of research funding at Alzheimer’s Research UK, who was not involved in the study, said the research offers a practical way to understand healthy aging.
“Rather than focusing only on the chances of developing dementia, this study asks a question that matters to people: how long can we expect to live free from dementia?” Hanley said.
She said the findings reinforce the importance of maintaining cardiovascular health because conditions such as high blood pressure and diabetes increase the risks of both dementia and premature death.
Hanley urged people to stay physically active, avoid smoking and manage chronic conditions such as hypertension and diabetes.
“While there is no guaranteed way to prevent dementia, research, including this study, suggests that addressing risk factors for poor cardiovascular health may also help reduce the risk of cognitive decline and dementia,” she said.
