Midlife Vascular Health Linked to Up to 12.6 More Dementia-Free Years

Maintaining optimal vascular health in midlife was associated with up to 12.6 additional years of life free from dementia between ages 55 and 95. The prospective analysis of 12,409 participants from the US Atherosclerosis Risk in Communities (ARIC) study followed for a median of 26.3 years, evaluated three major midlife vascular risk factors—diabetes, high blood pressure, and current smoking. Compared with individuals with no risk factors, those with all three had a 2.69-fold higher risk of developing dementia and a 5.61-fold higher risk of dying before developing dementia. Dementia-free survival declined markedly as vascular risk burden increased, from 30.1 years in those with no risk factors to 17.5 years in those with all three. Although the highest-risk group developed dementia at younger ages, their cumulative dementia incidence by age 95 was lower because many died earlier from other causes. Women experienced longer dementia-free survival than men despite similar vascular risk burden, while Black participants had shorter dementia-free survival than White participants. These findings suggest that preserving vascular health in midlife can substantially extend years lived free of dementia and provide a simple, patient-centered way to communicate the long-term benefits of cardiovascular risk prevention. Source: https://www.neurology.org/