Caring for the heart may also mean caring for the brain. This conclusion was reached by the authors of a new study published in the scientific journal *Neurology*. Researchers found a connection between three important vascular risk factors—smoking, diabetes, and blood pressure abnormalities—and the number of years a person lives without dementia, [reports](https://www.health.com/midlife-vascular-risk-avoid-dementia-12033666) Health. According to one of the study's authors, Joseph Cores, director of the Institute for Optimal Aging at NYU Grossman School of Medicine, prevention does not mean that dementia can be completely eliminated. However, it can delay the onset of the disease and provide a person with additional years of healthy life. ## Almost 13 Years Difference Researchers observed **12,409 adult residents from four regions of the U.S.** from the early 1990s until 2022. The average age of participants at the beginning of the study was 56 years. Volunteers underwent medical examinations at the start of the observations and again approximately 26 years later. To determine cases of dementia, researchers used cognitive tests, telephone interviews, hospitalization records, and mortality data. The results were quite striking. People who **did not smoke, did not have diabetes, and did not have high or low blood pressure** had an average of **30.1 years of life without dementia** between the ages of 55 and 95. Participants who had all three risk factors had only **17.5 years**. Thus, the difference reached **12.6 years**—almost 13 years. At the same time, researchers point out an important detail: people with the worst vascular health often died before dementia could develop. This circumstance may also have influenced the results obtained. ## Why Vascular Health is Linked to the Brain The link between cardiovascular health and brain condition is not new to researchers. Smoking, high blood pressure, and diabetes can damage blood vessels that supply the brain with blood. Consequences can include strokes, impaired blood flow to the brain, and chronic inflammatory processes. A unique aspect of the new study is that researchers assessed results not only through risk percentages but also calculated **the number of years lived without dementia**. According to Cores, this measure is much clearer for both doctors and patients. ## Does This Mean It's Enough to Avoid Smoking and Monitor Blood Pressure and Sugar? Not quite. The benefits of quitting smoking, controlling blood pressure, and managing blood sugar levels for health are well known. However, the authors emphasize that the results of this study do not, by themselves, prove that these three factors directly provide additional years without dementia. There are several important limitations. Only **176 participants in the study had all three risk factors** simultaneously, which is a relatively small group. Additionally, the risk factors were assessed only once—at midlife. The study was observational, so it allows for establishing a connection but does not prove a direct cause-and-effect relationship. There are also other possible explanations. For example, people who monitor their blood pressure may also exercise more, sleep better, and have better access to healthcare. All of this can also influence the likelihood and timing of dementia development. ## Processes May Begin Decades Before Diagnosis Nir Barzilai, a professor of genetics and medicine at the Albert Einstein College of Medicine who did not participate in the study, points out the possible influence of other lifestyle factors. At the same time, Rudy Tanzi, a professor of neurology at Harvard Medical School, finds the discovered connection quite understandable. According to him, if dementia or Alzheimer's disease manifests in a person, for example, at age 80, the pathological processes in the brain may have begun around age 50. Therefore, lifestyle in midlife can potentially influence how these processes will develop in the following decades. ## Not Just Three Rules Despite the encouraging results, experts advise against considering quitting smoking and controlling blood pressure and diabetes as a universal formula for protecting against dementia. Many factors influence brain health as one ages. Rudy Tanzi recommends paying attention to getting enough sleep, maintaining a healthy diet, and limiting the intake of ultra-processed foods whenever possible. Additionally, it makes sense to monitor health indicators such as **cholesterol levels and body mass**. Thus, the conclusion of the study is not about the existence of three "magic" rules that can guarantee the prevention of dementia, but rather that **vascular health in midlife can significantly impact how many years a person will live without serious cognitive impairments**.
