A new study has found that avoiding high blood pressure, diabetes, and smoking between the ages of 45 and 65 is linked to adding over 12 years free of dementia, on average, to a person’s lifespan.
“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 Josef Coresh, MD, PhD, professor of population health and medicine, and founding director of the Optimal Aging Institute at the NYU Grossman School of Medicine. “Discovering new ways to delay dementia is crucial with 42% of Americans at risk for developing the condition at any time after age 55.”
Results published today in the Neurology journal also show that the benefits were not equal across all demographics. Even when exposed to all three risk factors, women and White individuals were more likely to live longer without dementia than men and Black participants, respectively.
Coresh and colleagues analyzed data from the Atherosclerosis Risk in Communities (ARIC) study, which started in 1986 and tracked vascular risk factors and dementia outcomes over several decades. The analysis included more than 12,000 middle-aged participants who were free of dementia at the start of the study and focused on three well-established risk factors of dementia: high blood pressure, diabetes, and smoking.
Participants were an average of 56 years old at enrollment and were followed for an average of 26 years. During that time, over 3,000 participants developed dementia, while more than 5,000 died without developing the condition.
Those with none of the three risk factors remained free of dementia for 30.1 years after the start of the study, compared to 17.5 years for those with all risk factors—a difference of 12.6 years.
Regardless of the number of risk factors, women lived longer than men without developing dementia. Among participants with all three risk factors, women lived dementia-free for an average of 18.1 years, compared to 16.6 years for men.
Similarly, White participants lived longer without dementia than Black participants independently of the number of risk factors involved. When all three risk factors were present, White individuals lived dementia-free for an average of 19.6 years, compared to 16 years for Black participants.
“Finding ways to prevent or delay dementia is crucial as the population ages as treatments remain limited,” said Coresh. “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.”
Because this was an observational study, it cannot establish a causal link between risk factors and a delay in dementia onset. Still, the findings highlight marked differences and support the prevention and monitoring of these key risk factors beginning from age 45.
“People with all three risk factors were more likely to develop dementia or die at earlier ages from other causes, leading to shorter overall survival and fewer years with their thinking and memory abilities intact,” Coresh said. “Hopefully these results will help encourage people to stop smoking, manage their blood sugar, and manage their blood pressure in midlife. Of course, other healthy habits such as eating better and being more active are also important.”
