NEW YORK (WOWO) — Keeping blood pressure under control, avoiding diabetes and not smoking in middle age could be associated with nearly 13 additional years of life without dementia, according to research led by investigators at NYU Langone Health.

The study followed more than 12,000 adults for an average of 26 years and examined how three vascular health factors — high blood pressure, diabetes and smoking — were associated with the number of years people lived without dementia.

Researchers found that people with none of those three risk factors at midlife were expected to live an average of 30.1 additional years without dementia starting at age 55.

That compared with 17.5 dementia-free years for people who had all three risk factors — a difference of 12.6 years.

The findings were published in the journal Alzheimer’s & Dementia.

The study does not show that controlling those conditions will guarantee someone avoids dementia. Instead, it found an association between a person’s vascular health in midlife and the amount of time they were expected to live without dementia.

Researchers say the results highlight the importance of addressing cardiovascular health before old age, when high blood pressure and diabetes can become established and smoking-related damage can accumulate.

“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 senior investigator Dr. Josef Coresh, according to a statement cited in the research coverage.

The analysis used data from the Atherosclerosis Risk in Communities, or ARIC, study, a long-running research project that began in 1986.

Researchers examined 12,409 participants who were free of dementia at the beginning of the analysis. Their average age was about 56, and 56% were women. About one-quarter of the participants were Black adults. Overall, 57.5% had at least one of the three vascular risk factors being studied.

Participants were categorized according to whether they had zero, one, two or three of the risk factors.

The difference in dementia-free life expectancy became progressively larger as the number of risk factors increased.

People with one risk factor were expected to have about 26.3 years of dementia-free life remaining at age 55.

Those with two risk factors had about 21 years.

People with all three had 17.5 years.

Those without any of the three had 30.1 years.

That means the gap between having no identified vascular risk factors and having all three was roughly 13 years.

The researchers also found that a higher vascular risk burden was associated with greater mortality before dementia. That distinction is important because the study’s results should not be interpreted as meaning that people with fewer risk factors necessarily have a lower lifetime probability of ever developing dementia.

In fact, the researchers calculated that the estimated lifetime risk of dementia was 42% among people with no vascular risk factors, compared with 23% among those with all three.

The seemingly counterintuitive result was largely explained by higher mortality among people with greater vascular risk. In other words, people with multiple risk factors were more likely to die before developing dementia, reducing the proportion who ultimately reached a dementia diagnosis.

Among participants who did develop dementia, those without the three vascular risk factors lived an average of 4.1 years with dementia, compared with about three years among people who had all three.

The study’s three risk factors were defined using specific measures. Diabetes included a self-reported diagnosis, diabetes medication use or an elevated HbA1c level. Hypertension was defined in the study using a blood pressure threshold of at least 140 over 90 millimeters of mercury or the use of blood-pressure medication. Smoking status was based on participants’ reports, with people who were not current smokers serving as the reference group.

The findings add to a growing body of research connecting cardiovascular and brain health.

High blood pressure can damage blood vessels throughout the body, including those supplying the brain. Diabetes can also contribute to blood-vessel damage and other changes associated with cognitive decline. Smoking is linked to cardiovascular disease and stroke, both of which can affect brain health.

Earlier research has also found that multiple vascular risk factors can compound dementia risk. A 2025 JAMA Neurology study using ARIC data, for example, examined the combined relationship between hypertension, diabetes and current smoking and dementia risk by age 80.

The latest analysis, however, focuses on a different question: not simply whether someone develops dementia, but how many years they can expect to live without it.

Researchers say that distinction provides a more practical way to understand the potential consequences of vascular health in middle age.

The study also found differences by sex and race.

Women generally had more dementia-free years than men across the different levels of vascular risk. Among people with all three risk factors, women had an estimated 18.1 dementia-free years compared with 16.6 years for men.

The analysis also found racial differences. Among people with all three risk factors, White participants had an estimated 19.6 dementia-free years, compared with 16.0 years among Black participants.

The researchers said those differences point to the importance of targeted prevention efforts while also emphasizing that improving vascular health could benefit people across demographic groups.

Coresh said he hopes the findings encourage people to stop smoking and pay closer attention to their cardiovascular health beginning in midlife.

The researchers caution that their work has limitations. Because the analysis was observational, it cannot establish that high blood pressure, diabetes or smoking directly caused an individual to develop dementia earlier. The study also reflects the health characteristics and experiences of the ARIC population and relies on measurements and health information collected over a long period.

Still, the researchers say the findings reinforce the importance of identifying and managing vascular risks well before old age.

The underlying research was first published in December 2025 in Alzheimer’s & Dementia, rather than being a newly published 2026 study. The paper’s authors concluded that a greater burden of midlife vascular risk factors was associated with earlier dementia and as much as a 13-year reduction in dementia-free life expectancy, with higher mortality accounting for much of the difference.

For people in their 40s, 50s and 60s, the takeaway is straightforward: don’t wait until old age to address heart and vascular health.

Keeping blood pressure in a healthy range, preventing or managing diabetes and avoiding smoking are all established components of cardiovascular health — and this study suggests those same efforts may also help people spend more of their later years without dementia.