August 12, 2026
Avoiding three risk factors for Alzheimer’s disease in midlife may allow you to live 13 years longer without dementia, according to a new analysis. The study found that men and women in their 50s who had a healthy blood pressure, did not have diabetes and did not smoke were far less likely than their peers who had one or more of these conditions to develop dementia in the ensuing decade plus. The findings underscore the importance of prevention in helping to curb or delay the onset of Alzheimer’s disease in old age.
“Our findings support prevention of risk factors developing in midlife as a strategy for delaying the onset of dementia and maintaining brain health,” said study author Dr. Josef Coresh of the NYU Grossman School of Medicine in New York. “Finding ways to prevent or delay dementia is crucial as the population ages as treatments remain limited.”
For the study, researchers looked at 12,409 men and women whose average age was 56. None had Alzheimer’s disease or other forms of dementia at the study’s start. All were part of the Atherosclerosis Risk in Communities (ARIC) Study, which started in 1986 and followed men and women living in communities in Minnesota, Maryland, Mississippi and North Carolina over several decades from middle age into late life.
The study looked at various risk factors affecting the heart and vascular health, which can also affect the health of the brain. Participants were assessed for three risk factors in their mid-50s: high blood pressure, diabetes and smoking. High blood pressure was defined as having a blood pressure exceeding 140/90 or taking a medication to lower blood pressure.
The researchers followed them for an average of 26 years. During that time, 3,008 developed Alzheimer’s disease or another form of dementia, while 5,238 of the study group died without developing dementia.
People who had none of the three heart and vascular risk factors in their 50s lived without developing dementia nearly 13 years longer than people with all three of the risk factors. Those with none of the risk factors lived for an average of more than 30 years after the start of the study without developing dementia, compared to about 17.5 years for those with all three risk factors. Women, who on average live longer than men, tended to live longer dementia-free than men regardless of how many risk factors they had.
“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,” Dr. Coresh noted. “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.” The findings were published in the journal Neurology Open Access, from the American Academy of Neurology.
The study showed only an association between avoiding these three risk factors and a lower likelihood of developing dementia and cannot prove cause and effect. But a large body of research has linked these and other risk factors to a lower risk of developing Alzheimer’s disease in old age.
The Lancet Commissions, a scientific group, estimates that around 45 percent of cases of dementia are potentially preventable by addressing 14 modifiable health and lifestyle factors at different stages of life. In addition to the risk factors noted, they include formal years of schooling early in life; hearing loss, high cholesterol, obesity, traumatic brain injury, physical inactivity and excessive alcohol consumption in midlife; and social isolation, vision impairment and exposure to air pollution later in life.
“Discovering new ways to delay dementia is crucial, with 42 percent of Americans at risk for developing the condition at any time after age 55,” said Dr. Coresh. “Hopefully, these results will encourage people to stop smoking and watch their vascular health closely,” and the earlier, the better.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, PhD, of The Fisher Center lab at The Rockefeller University.
Source: Jiaqi Hu, Josef Coresh, Jason R. Smith, et al: “Midlife vascular risk burden and dementia-free survival years: The Atherosclerosis Risk in Communities Neurocognitive Study.” Neurology Open Access, August 5, 2026
