What if your brain's retirement plan starts with today's blood pressure, blood sugar, and smoking habits?
Keeping blood pressure under control, avoiding diabetes, and not smoking during midlife may help people stay free from dementia for much longer, according to a new study published in Neurology Open Access. Researchers found that adults with none of these three vascular risk factors lived nearly 13 years longer without dementia than those with all three.
The study followed 12,409 adults with an average age of 56 who were free of dementia at enrollment. Participants were assessed for high blood pressure, diabetes, and smoking, then tracked for an average of 26 years. During follow-up, 3,008 people developed dementia, while 5,238 died without developing the condition.
People with no vascular risk factors remained dementia-free for an average of 30.1 years, compared with 17.5 years among those with all three risk factors. Women generally lived longer without dementia than men, regardless of risk profile. Women with all three risk factors remained dementia-free for an average of 18.1 years, compared with 16.6 years for men.
Researchers believe the findings reinforce the importance of preventing vascular risk factors in midlife, when changes may have the greatest long-term impact on brain health. High blood pressure was defined as above 140/90 mmHg or the use of blood pressure-lowering medication.
However, the researchers stress that the study shows an association, not cause and effect. It cannot prove that controlling blood pressure, preventing diabetes, or quitting smoking directly delays dementia.
Even so, the results add to growing evidence that protecting heart health may also help protect the brain. Alongside not smoking and managing blood pressure and blood sugar, experts continue to recommend a healthy diet, regular physical activity, and other heart-friendly habits to support healthy brain aging.
REFERENCE: Jiaqi Hu, Josef Coresh, et al.; Midlife Vascular Risk Burden and Dementia-Free Survival Years; Neurology Open Access; 2026; https://doi.org/10.1212/WN9.0000000000000152
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