Dementia-free years may decrease with smoking, hypertension, and diabetes
August 25, 2026
Dementia-free years may decrease with smoking, hypertension, and diabetes
At a Glance
- Researchers found that smoking, high blood pressure, and diabetes in midlife lower the number of years a person is likely to live without dementia.
- The findings could help guide behavior and lifestyle changes to prevent dementia.
Dementia may affect about half of older adults in the United States by 2060. As the baby boomer generation ages in the coming decades, the number of people over age 55 with dementia is expected to rise sharply. This could lead to large societal costs and highlights the need to identify ways to prevent or delay dementia.
Dementia affects a person’s ability to think, remember, and reason. Poor heart and vascular health is an important risk factor for dementia among older adults. Smoking, diabetes, and high blood pressure can contribute to poor vascular health as well as dementia risk. How these vascular risk factors affect when dementia develops or how long people live without it is not fully understood.
A research team led by Dr. Josef Coresh at New York University Grossman School of Medicine studied this question by analyzing data from a study of four U.S. communities collected over three decades. They tracked whether and when participants developed dementia and how long they lived. This allowed the team to examine the relationship between vascular risk factors and years of life without dementia. The results were reported in Neurology Open Access on August 5, 2026.
The research team focused on 12,409 study participants who did not have dementia at age 55 in the early 1990s. Participants’ diabetes, blood pressure, and smoking status were assessed at that time. Of the participants, 5,271 (42%) lacked any of these vascular risk factors at the time of the assessment. The researchers then reviewed participants’ regular health assessments through 2022.
During the study period, 3,008 people developed dementia and 5,238 people died without having developed dementia. The researchers found that vascular risk factors led to greater risk of dementia or dying without dementia.
The more vascular risk factors a person had, the fewer years they lived dementia-free. People with no risk factors lived on average 13 years longer without dementia than people who had three risk factors. Those with no risk factors lived about 30 years past age 55 without dementia. Those with three risk factors lived about 17 years without dementia.
The researchers also found differences among groups. Women lived on average 1.5 to three years longer without dementia than men with the same number of risk factors. Black participants lived about three fewer years without dementia than White participants.
The study suggests that vascular risk factors are linked to developing dementia at an earlier age. More research is needed to understand the impact of changes in vascular health over time.
Many vascular risk factors can be reduced through changes in behavior, medical care, and lifestyle. Developing strategies to help people avoid these risk factors could delay dementia onset.
“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,” Coresh says. “Hopefully, these results will give people another reason to stop smoking and watch their vascular health closely.”
—by Laura Manella, Ph.D.
Related Links
- Alzheimer’s proteins in blood linked to midlife cognition
- Team-based care improves blood pressure control
- Severe CTE clearly linked to dementia
- People with dementia prescribed risky drugs
- Risk and future burden of dementia in the United States
- Diagnosing dementia
- Preventing diabetes
- Stopping Middle-Age Spread
- Atherosclerosis Risk in Communities (ARIC) Study
- Diabetes
- Alzheimer’s and dementia
- What is high blood pressure?
- Tobacco/nicotine and vaping
References
Midlife Vascular Risk Burden and Dementia-Free Survival Years: The Atherosclerosis Risk in Communities Neurocognitive Study. Hu J, Coresh J, Smith JR, Sharrett AR, Gottesman RF, Lutsey PL, Mosley TH, Selvin E, Fang M, Weiss J. Neurology Open Access. Aug 5. doi: 10.1212/WN9.0000000000000152. Online ahead of print.
Funding
NIH’s National Heart, Lung, and Blood Institute (NHLBI), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Neurological Disorders and Stroke (NINDS); National Natural Science Foundation of China.
