Keeping blood pressure under control, avoiding type 2 diabetes, and abstaining from smoking during midlife can significantly reduce the risk of dementia later in life. A new long-term study shows that people who had none of these three risk factors lived on average almost 13 years longer without dementia compared to those who had all three.

Researchers at NYU Langone Health analyzed data from the extensive American ARIC study (Atherosclerosis Risk in Communities), which has followed participants for several decades. The results, published in the scientific journal Neurology, indicate that health between ages 45 and 65 plays a crucial role in the future health of the brain.

Nearly 13 Extra Years Without Dementia

The new analysis included 12,409 people with an average age of 56. None of the participants had dementia when the study began. The researchers examined three well-established risk factors for cardiovascular disease: high blood pressure, type 2 diabetes, and smoking. Participants were then followed for an average of 26 years. During the follow-up, 3,008 people developed dementia, while 5,238 died without being diagnosed.

The results showed a clear link between the number of risk factors in midlife and how long the participants lived without dementia: No risk factors: on average 30.1 dementia-free years. One risk factor: 26.3 dementia-free years. Two risk factors: 21.0 dementia-free years. Three risk factors: just over 17 dementia-free years. The difference between people with none and all three risk factors was therefore nearly 13 years.

The Importance of Acting Early

“Our results suggest that people should actively prevent these risk factors in midlife as a strategy to maintain brain health for more than a decade,” says the study’s lead author, Professor Josef Coresh at NYU Langone Health, to The Guardian.

“Hopefully, the results can encourage more people to quit smoking and closely monitor their vascular health from age 45 onwards,” he continues.

The researchers emphasize that the three risk factors often develop during midlife and can affect the aging of the brain over a long period, making early detection and treatment particularly important.

The Heart and Brain are Connected

According to the researchers, the study reinforces the view that good cardiovascular health also benefits the brain. High blood pressure, diabetes, and smoking can damage blood vessels over many years, which in turn can contribute to neurodegenerative changes and increase the risk of dementia.

Dr Jacqui Hanley, Director of Research at Alzheimer’s Research UK, who was not involved in the study, also considers the results significant.

“Instead of only focusing on the risk of developing dementia, this study asks a question that is important for people: How long can we expect to live without dementia?”

She believes the results show how health in midlife can influence the number of years a person can maintain cognitive abilities.

“These results underscore why it is so important to take care of both heart and brain health,” she tells The Guardian.

Dementia Expected to Increase Sharply

The number of people living with dementia worldwide is expected to nearly triple to about 153 million by 2050. At the same time, researchers estimate that a significant share of cases could be prevented or delayed by influencing risk factors throughout life.

Previous research has indicated that up to 45 percent of all dementia cases could be prevented or delayed by reducing a number of modifiable risk factors.