Researchers from NYU Langone Health identified three midlife health measures—normal blood pressure, no type 2 diabetes, and not smoking,that are associated with an additional 13 years of dementia-free life, on average.

Longitudinal Study Tracks Decades of Health Data

The findings, published in the journal Neurology, stem from a longitudinal study of 12,409 people with an average age of 56 who were initially free of dementia. The participants were assessed for three risk factors: high blood pressure, type 2 diabetes, and smoking.

Participants were followed for about three decades, with an average follow-up of 26 years, as During that time, 3,008 participants developed dementia, and 5,238 died without developing the condition.

Differences in Dementia-Free Lifespan by Gender and Race

The study also found that, regardless of how many risk factors individuals had, women lived longer without dementia than men, though Plus, white participants had more dementia-free years than Black participants.

Those who had none of the three risk factors lived without developing dementia for nearly 13 years longer than those who had all three. People without diabetes, high blood pressure, and who did not smoke at the start of the study had an average of 30.1 more years free of dementia.

Those with one risk factor had an extra 26.3 years, those with two had 21 years, and those with all three had just over 17 years of dementia-free life.

Call to Action for Midlife Health

“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 senior investigator Dr. Josef Coresh, director of the Optimal Aging Institute at NYU Langone.

Coresh emphasized the importance of managing vascular health from age 45 onward — “Hopefully, these results will encourage people to stop smoking and watch their vascular health closely from age 45 on,” he added.

The global population living with dementia is projected to nearly triple to 153 million by 2050; However, experts believe almost half of dementia cases worldwide could be prevented or delayed through lifestyle and health interventions.

Previous research suggests that addressing 14 modifiable risk factors,starting in childhood and continuing throughout life,could prevent or delay 45% of dementia cases, even as people live longer.

The NYU Langone study highlighted that the three identified factors “often emerge in midlife” and “exert lasting effects on neurodegenerative pathology,” highlighting the importance of early identification and management.

Dr. Jacqui Hanley, head of research funding at Alzheimer’s Research UK, noted the significance of this approach. “Rather than focusing only on the chances of developing dementia, this study asks a question that matters to people: how long can we expect to live free from dementia?”

“This approach gives a meaningful picture of how midlife health may shape the number of years we spend living free from dementia, while also recognising that high blood pressure, diabetes and smoking are linked to a higher likelihood of dementia as well as a greater risk of dying earlier from other conditions,” Hanley said.

She recommended practical steps for individuals, including staying physically active, not smoking, and managing conditions such as high blood pressure and diabetes. “While there is no guaranteed way to prevent dementia, research, including this study, suggests that addressing risk factors for poor cardiovascular health may also help reduce the risk of cognitive decline and dementia.”