Avoiding These Three Vascular Health Risk Factors in Midlife Can Help You Delay Dementia for About 13 Years, Study Suggests

High blood pressure, diabetes and smoking are three major modifiable risk factors of dementia. New research tracked more than 12,000 participants to quantify how many years of healthy cognitive function you can gain by evading some or all of them during middle age

Sarah Kuta | Daily Correspondent

August 18, 2026 10:00 a.m.

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Up to four in 10 Americans who reach age 55 can go on to develop dementia, with the risk rising sharply as they age. But new research suggests that avoiding three specific risk factors in middle age could help delay cognitive decline, potentially giving people more years of healthy brain function.

A study published August 5 in the journal Neurology Open Access found that people who avoided high blood pressure, diabetes and smoking in midlife had, on average, about 12.6 more dementia-free years than those with all three risk factors.

Past studies have linked vascular health and brain health, suggesting that what’s good for the heart may also help protect the brain. But with the new work, researchers hoped to frame that connection in a different way—not just as reduced risk, but as time gained without dementia.

“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?” Jacqui Hanley, who leads research funding at the nonprofit Alzheimer’s Research U.K. and was not involved with the study, tells the Guardian’s Andrew Gregory. “This approach gives a meaningful picture of how midlife health may shape the number of years we spend living free from dementia.”

To find that number, researchers followed 12,409 U.S. adults for approximately 26 years, periodically giving them cognitive tests and interviewing them over the phone. At the beginning of the study, the participants had an average age of 56 and were dementia-free. But some of them smoked, had high blood pressure or had diabetes—or some combination of the three—while others didn’t. These vascular factors were chosen because all three are major modifiable risk factors, or conditions that a person can change, linked with dementia and death.

Health and death records revealed that 3,008 of the participants went on to develop dementia, while 5,238 died without experiencing the condition. Individuals who had all three risk factors at midlife were 2.7 times as likely to develop dementia as those who had none, the team found. What’s more, participants who avoided the risk factors at middle age enjoyed an average of 30.1 dementia-free years, while those who had all three had 17.5 dementia-free years.

“By avoiding a few risks in midlife, you get more than a decade free of both dementia and death,” study co-author Josef Coresh, an epidemiologist and aging researcher at New York University’s Grossman School of Medicine, tells New Scientist’s Carissa Wong.

You don’t have to avoid all three risk factors in middle age to see a benefit, according to the study. Compared to participants who experienced all three, those who avoided just one risk factor at midlife gained an estimated four additional dementia-free years, while those who avoided two got another nine years.

Still, the study can’t prove that avoiding smoking, high blood pressure and diabetes directly caused the dementia delay, only that there is an association between their absence and years without the cognitive condition. And improving heart health isn’t a fix-all—other factors, like diet, genetics and exposure to environmental pollution, can influence the risk of cognitive decline. But with no known cure for dementia, research suggests it’s one of the steps people can take to help protect their brain health as they age.

“Many of us really feel that our best chance of defeating [dementia], which has been stumping the field for a long time, is to start early,” Heather Whitson, a geriatrician and aging biologist at Duke University School of Medicine who wasn’t involved with the research, tells the Washington Post’s Erica Sloan.

And even if you already have some vascular risk factors, it’s never too late to take action: Midlife may still offer opportunities to improve your cardiovascular health and protect your brain.

“Fifty-five [years old] is a great time to drastically improve your future of vascular health, both in your body and in your brain, and that also means slowing down dementia,” Anna Nordvig, a neurologist at Weill Cornell Medicine and NewYork-Presbyterian who was not involved with the study, tells NBC News’ Lily Alvino.

Sarah Kuta is a writer and editor based in Longmont, Colorado. She covers history, science, travel, food and beverage, sustainability, economics and other topics.