3 Midlife Health Factors That Could Delay Dementia by 13 Years

Avoiding high blood pressure, diabetes, and smoking between the ages of 48 and 68 is associated with an average of 13 additional dementia-free years, according to a study led by NYU Langone Health. The research, published August 5 in Neurology Open Access, suggests that managing these three vascular risk factors in midlife can significantly delay the onset of dementia.

Researchers analyzed data from the community-based Atherosclerosis Risk in Communities (ARIC) Study, which began in 1986. The team tracked 12,409 people with an average age of 56 who did not have dementia at the start of the observation. Over an average follow-up period of 26 years, 3,008 participants developed dementia, while 5,238 died without the condition.

The study found a stark difference in outcomes based on these risk factors. Participants who avoided all three risk factors lived an average of 30 years after the study’s start without developing dementia. In contrast, those with all three risk factors lived an average of 17 years before dementia onset, a difference of nearly 13 years.

Demographic Differences in Dementia-Free Survival

The NYU Langone Health data revealed that dementia-free lifespans vary by gender and race, regardless of the number of risk factors present. Women generally lived longer without dementia than men. Specifically, women with all three risk factors lived an average of 18.1 years without dementia, compared to 16.6 years for men, according to the study.

Disparities were also evident across racial groups. White participants with all three risk factors lived an average of 19.6 years without dementia, while Black participants with the same risk factors lived an average of 16.0 years. Dr. Josef Coresh, study senior investigator and founding director of the Optimal Aging Institute, stated that these results suggest Black adults may especially benefit from targeted prevention efforts.

Midlife Prevention and Brain Health

The study emphasizes the importance of the window between ages 48 and 68 for preserving cognitive function. Dr. Coresh noted that discovering ways to delay dementia is critical because 42 percent of Americans are at risk of developing the condition at any time after age 55.

While the three vascular factors were the focus, other modifiable risks contribute to overall brain health. According to reporting from Time, additional ways to lower dementia risk include:

• Maintaining regular physical activity and a balanced diet
• Keeping the brain active and staying social
• Managing cholesterol levels and hearing loss
• Reducing alcohol consumption and exposure to air pollution
• Maintaining a healthy weight

World Health Organization guidelines estimate that addressing all modifiable risk factors could avoid 45 percent of dementia cases, as reported by Time.

Study Limitations and Non-Modifiable Risks

The researchers noted that the study was not designed to prove that avoiding these vascular risk factors caused the delay in dementia, only that an association exists. Another limitation was that risk factors were measured only once, meaning the study did not capture changes in a participant’s health status over time.

Some risk factors remain outside of a person’s control. Dr. Jeffrey Kaye, a professor of neurology and biomedical engineering at Oregon Health & Science University, told Time that age is the single greatest risk factor. About one in 13 people aged 65 to 84 have Alzheimer’s disease; for those 85 and older, that figure rises to approximately one in three. Genes, race, and gender also influence the likelihood of developing dementia.

The research was supported by National Institutes of Health grants, including K24 HL152440 and K01 DK138273. The ARIC study was funded through multiple NIH grants, including U01HL096812 and U01HL096899.