Vascular Burden in Midlife Linked to Increased Risk for Dementia, Death

THURSDAY, Aug. 6, 2026 (HealthDay News) — Maintaining optimal midlife vascular health is associated with more dementia-free survival years, according to a study published online Aug. 5 in Neurology Open Access.

Jiaqi Hu, Ph.D., from Tsinghua University in Beijing, and colleagues estimated dementia-free survival from age 55 to 95 years according to midlife vascular risk burden in the Atherosclerosis Risk in Communities study. Participants had measurements of diabetes (self-report, medication use, or hemoglobin A1c ≥6.5 percent), hypertension (blood pressure ≥140/90 mm Hg or medication use), and current smoking in 1990 to 1992; the count of these risk factors was used to define vascular burden.

Overall, 3,008 of 12,409 participants developed dementia during a median of 26.3 years and 5,238 died dementia-free. The researchers found that having three risk factors was associated with higher hazards of dementia and death without dementia compared with zero risk factors (hazard ratios, 2.69 and 5.61, respectively). Fewer dementia-free survival years were seen in association with higher vascular burden, declining from 30.1 to 17.5 years for zero and three risk factors, respectively. The cumulative incidence of dementia increased earlier but was lower by age 95 years in the highest-risk group due to substantially greater competing mortality. Compared with men, women lived longer dementia-free (18.1 versus 16.6 years with three risk factors). Shorter dementia-free survival was seen for Black versus White participants (16.0 versus 19.6 years).

“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,” senior author Josef Coresh, M.D., Ph.D., from the NYU Grossman School of Medicine in New York City, said in a statement.

Abstract/Full Text