3 things to avoid in middle age could mean 13 more years without dementia, study finds

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Middle-aged adults who manage to avoid high blood pressure, diabetes and smoking can gain nearly 13 additional years of life free from dementia, according to new research led by NYU Langone Health.

The study, published in the journal Neurology Open Access, analyzed long-term health data to determine how midlife cardiovascular wellness shapes brain function decades later.

Minimizing these three common vascular threats between ages 48 and 68 dramatically postpones mental decline, according to the research.

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“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, the study’s senior investigator and founding director of the Optimal Aging Institute at NYU Langone, in a press release.

Identifying actionable ways to stall memory loss is vital, he said, pointing out that roughly 42% of Americans are projected to develop dementia after turning 55.

Maintaining normal blood pressure, avoiding diabetes and refraining from smoking between ages 48 and 68 is associated with nearly 13 additional years of dementia-free life, the study suggested. (iStock)

The reviewed data came from the Atherosclerosis Risk in Communities study, an ongoing trial that began in 1986. It included a cohort of more than 12,000 dementia-free participants whose average age was 56.

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After screening subjects for smoking habits, elevated blood pressure and diabetes, researchers tracked their health trajectories for an average of 26 years.

By the end of the observation window, 3,008 participants had developed dementia, while 5,238 died without cognitive impairment.

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The study revealed a significant gap based on midlife health: Participants who avoided all three risk factors averaged 30 dementia-free years following their baseline exams. In contrast, those with all three conditions averaged just 17 years before developing dementia or dying.

A woman reads the blood pressure of a patient.

Experts emphasize that targeted cardiovascular prevention efforts starting in midlife are essential to preserve brain health, particularly with 42% of Americans at risk for developing dementia after age 55. (FG Trade / Getty Images)

Demographic trends were reported across sex and race. Female participants had longer periods of cognitive health than male participants, regardless of health risks.

Among subjects with all three risk factors, women survived an average of 18.1 years without dementia, compared to 16.6 years for men.

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White participants with all three risk factors averaged 19.6 dementia-free years, while Black participants facing the same health profile averaged 16.0 years.

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“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 said, expressing hope that the data will motivate people to quit smoking and monitor cardiovascular health starting in their late 40s.

Woman taking blood pressure

Women consistently experienced more years of cognitive health than men across all risk levels, averaging 18.1 dementia-free years with all three risk factors present compared to 16.6 years for men. (iStock)

The authors noted several limitations to their findings, including that the observational design cannot prove direct cause and effect.

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Additionally, health status was recorded during a single visit, and some potential midlife lifestyle changes were unreported.

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