Avoiding 3 risk factors associated with living 13 more years without dementia
American Academy of Neurology
Highlights:
- Having normal blood pressure, no diabetes and not smoking was associated with living nearly 13 years longer without dementia.
- The study does not prove that avoiding these vascular risk factors causes the delay in dementia; it only shows an association.
- A limitation of the study was that the assessment of risk factors happened once, so it focused on long-term outcomes after one assessment, not changes in risk factors over time.
MINNEAPOLIS — Having normal blood pressure, no diabetes and not smoking was associated with living nearly 13 years longer without dementia, according to a study published August 5, 2026, in Neurology® Open Access, an official journal of the American Academy of Neurology.
The study does not prove that avoiding these vascular risk factors causes the delay in dementia; it only shows an association.
“Our findings support prevention of risk factors developing in midlife as a strategy for delaying the onset of dementia and maintaining brain health,” said study author Josef Coresh, MD, PhD, of NYU Grossman School of Medicine in New York. “Finding ways to prevent or delay dementia is crucial as the population ages as treatments remain limited.”
The study involved 12,409 people with an average age of 56 who were free of dementia. People were assessed for three risk factors for dementia: high blood pressure, diabetes and smoking. High blood pressure was defined as blood pressure higher than 140/90 mmHg or the use of medication to lower blood pressure.
The participants were followed for an average of 26 years. During that time, 3,008 developed dementia and 5,238 people died without developing dementia.
People who had none of the risk factors lived without developing dementia nearly 13 years longer than people with all three of the risk factors. People with no risk factors lived for an average of 30.1 years after the start of the study without dementia. People with all three risk factors lived for an average of 17.5 years without developing dementia.
Female participants lived longer than male participants without developing dementia, regardless of how many risk factors they had. Female participants with all three risk factors lived an average of 18.1 years without developing dementia, compared to 16.6 years for male participants.
Coresh noted, “Women more often reach older ages and therefore experience many cases of late-onset dementia.”
White participants lived longer than Black participants without developing dementia, no matter how many risk factors they had. White participants with all three risk factors lived an average of 19.6 years without developing dementia, compared to 16.0 years for Black participants.
“People with all three risk factors were more likely to develop dementia or die at earlier ages from other causes, leading to shorter overall survival and fewer years with their thinking and memory abilities intact,” Coresh said. “Hopefully these results will help encourage people to stop smoking, manage their blood sugar and manage their blood pressure in midlife. Of course, other healthy habits such as eating better and being more active are also important.”
A limitation of the study was that the assessment of risk factors happened once, so it focused on long-term outcomes after one assessment, not changes over time.
The study was supported by the National Institutes of Health and the National Natural Science Foundation of China.
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Journal
Neurology
Avoiding three things during middle age is linked to 13 more years without dementia
NYU Langone Health / NYU Grossman School of Medicine
Having normal blood pressure, no diabetes, and not smoking from age 48 to 68, are associated with nearly 13 additional years on average of dementia-free life, a new study shows.
Led by NYU Langone Health researchers, the new 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, the presence of which was linked to both accelerated dementia onset and shortened overall dementia-free lifespans.
“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, MD, PhD, founding director, Optimal Aging Institute, NYU Langone. “Discovering new ways to delay dementia is crucial with 42 percent of Americans at risk for developing the condition at any time after age 55.” Dr. Coresh is also the Terry and Mel Karmazin Professor, Department of Population Health, NYU Langone.
For the new study, the researchers analyzed data in 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 people died without developing dementia. Those who had no risk factors lived without developing dementia nearly 13 years longer than people with the 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 to 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 to 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,” Dr. Coresh added. “Hopefully, these results will encourage people to stop smoking and watch their vascular health closely from age 48 on.”
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 the risk factor measurement was performed just once, so changes over time were not captured.
This study was supported by National Institutes of Health (NIH) grants K24HL152440 and K01DK138273, and the ARIC study was funded by grants NIH U01HL096812, U01HL096814, U01HL096899, U01HL096902 and U01HL096917.
Along with Dr. Coresh, study authors are Jiaqi Hu, Institute for Hospital Management, Tsinghua University in Beijing (lead author); Jason Smith, University of North Carolina School of Medicine; A. Richey Sharrett, Elizabeth Selvin and Michael Fang, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; Rebecca F. Gottesman, Stroke Branch, National Institute of Neurological Disorders and Stroke; Pamela Lutsey, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota; Thomas H. Mosley Jr., MIND Center, University of Mississippi Medical Center School of Medicine, Jackson; and Jordan Weiss, Department of Medicine (Division of Precision Medicine) and Optimal Aging Institute, NYU Grossman School of Medicine.
About NYU Langone Health
NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone No. 1 out of 118 comprehensive academic medical centers across the country four years in a row, and “U.S. News & World Report” recently ranked four of its clinical specialties No. 1 in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across seven inpatient locations, its Perlmutter Cancer Center, and more than 330 outpatient locations in the New York area and Florida. The system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.
Media Contact:
Greg Williams
Gregory.Williams@NYULangone.org
Journal
Neurology Open Access
Method of Research
Observational study
Subject of Research
People
Article Title
Midlife vascular risk burden and dementia-free survival years: The Atherosclerosis Risk in Communities Neurocognitive Study
Article Publication Date
5-Aug-2026
COI Statement
This study was supported by National Institutes of Health (NIH) grants K24HL152440 and K01DK138273, and the ARIC study was funded by grants NIH U01HL096812, U01HL096814, U01HL096899, U01HL096902 and U01HL096917.
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