Avoiding just three major health risks during middle age could add as much as 13 extra years free from dementia, according to new research that reinforces the growing link between heart health and brain health.
The study, led by researchers at New York University (NYU) Langone Health, found that maintaining normal blood pressure, avoiding diabetes and not smoking between the ages of 45 and 65 dramatically reduced the likelihood of developing dementia later in life.
Researchers analysed data from more than 12,000 adults who were free from dementia at the age of 55. Participants were tracked for an average of 26 years, allowing scientists to examine how three common cardiovascular risk factors influenced the onset of cognitive decline.
During the study period, just over 3,000 participants developed dementia, while around 5,200 died without ever receiving a dementia diagnosis.
The findings were striking. People who reached midlife without high blood pressure, diabetes or a smoking habit enjoyed an average of 30.1 additional years free from dementia. By comparison, those with one of the three risk factors remained dementia-free for around 26.3 years, those with two risk factors averaged 21 years, while people with all three experienced just over 17 dementia-free years.
Overall, participants who avoided all three risk factors gained nearly 13 extra years without dementia compared with those who had all three.
Dr Josef Coresh, director of the Optimal Aging Institute at NYU Langone Health, said the results underline the importance of looking after cardiovascular health long before old age.
“Our findings suggest people need to actively avert these factors in midlife as a strategy for preserving brain health for more than a decade,” he said.
The research adds to a growing body of evidence showing that many cases of dementia may be delayed, or even prevented, through healthier lifestyles. While age remains the greatest risk factor for dementia, scientists increasingly believe that lifestyle choices made decades earlier can significantly influence how the brain ages.
Previous studies have already highlighted the benefits of regular exercise, eating a balanced diet, limiting alcohol consumption, remaining socially active and avoiding smoking. Controlling blood pressure and reducing the risk of developing type 2 diabetes are also recognised as important ways of protecting both the heart and the brain.
The authors concluded that “individuals with no midlife vascular risk factors lived an average of 13 more dementia-free survival years compared to those with three risk factors.”
The study also identified differences between demographic groups. Women, regardless of how many risk factors they had, generally lived longer without dementia than men. White participants also experienced more dementia-free years than Black participants, although researchers noted that many factors—including differences in healthcare access, socioeconomic conditions and rates of chronic illness—may contribute to these disparities.
Experts not involved in the research welcomed the findings.
Dr Sonya Miller of TauRx Therapeutics Management said brain health deserves the same attention as physical health.
“With dementia now being the nation’s number one cause of death, we all need to take our brain health seriously and make the changes we can on an individual basis,” she said.
Dr Jacqui Hanley, Head of Research Funding at Alzheimer’s Research UK, stressed that while no lifestyle change can guarantee protection against dementia, reducing cardiovascular risk factors appears to lower the chances of cognitive decline.
Professor Ian Maidment of Aston University agreed, saying the study strengthens the growing consensus that “what is good for the heart is good for the brain.”
Although dementia cannot always be prevented, the message from researchers is increasingly clear. Looking after your health during middle age—by keeping blood pressure under control, preventing diabetes through a healthy lifestyle, and avoiding smoking—could significantly delay the onset of dementia and help preserve independence and quality of life well into older age.
