Jenn Gonick
Fri, August 14, 2026 at 10:26 AM UTC
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According to the National Institutes of Health (NIH), about 42% of Americans over the age of 55 will develop dementia at some point. Luckily, a growing body of research suggests there are concrete steps you can take to reduce your risk or delay the disease’s onset
Most recently, a study in Neurology found that just three lifestyle factors may add up to 12 dementia-free years to your life. For the study, the researchers observed more than 12,000 participants over an average of 26 years, investigating how three vascular risk factors—diabetes, high blood pressure, and smoking status—affected their risk of developing dementia and its age of onset. Ultimately, the researchers found that people who had fewer of these risk factors at midlife were both less likely to develop dementia and less likely to develop dementia at an early age. In fact, compared to participants with all three risk factors, participants with no risk factors had about 12.6 additional dementia-free years. (Participants with just one risk factor also had 8.8 more dementia-free years, while participants with two risk factors had 3.5.)
“This builds beautifully on an important 2024 Lancet Commission report, which identified 14 potentially modifiable risk factors for dementia. Diabetes, hypertension, and smoking are only part of that much larger picture,” says David Perlmutter, M.D., F.A.C.N., A.B.I.H.M., board-certified neurologist and author of Brain Defenders.“The message from both reports is increasingly difficult to ignore: a meaningful portion of dementia risk is related to factors we can potentially influence.”
So, what does all this mean for you? Ahead, neurologists break it down
Meet the experts:David Perlmutter, M.D., F.A.C.N., A.B.I.H.M., board-certified neurologist and author of Brain Defenders; Jeremy M. Liff, M.D., board-certified neurologist in New York City
Why are the findings significant?
The importance of the study’s findings is twofold. First, “they reinforce the idea that dementia is significantly preventable,” Dr. Perlmutter says. “To me, the important message is that brain health is very much connected to metabolic and vascular health, and what happens in midlife can have profound consequences decades later.” This is particularly important because we don’t yet have good treatments for dementia or Alzheimer’s disease, he notes
Second, the results show that the risk factors appear to be additive. “One risk factor is concerning; two are worse; and three are considerably worse,” Dr. Perlmutter says. “People with all three had about 2.7 times the hazard of developing dementia compared with those who had none.”
What’s the takeaway?
While there’s no way to completely eliminate the risk that you’ll develop dementia—and preventing or delaying the onset of diabetes or hypertension is a complex, multifactorial process as well—the study shows that you can take some important steps to reduce your dementia risk
“Threats to brain health begin long before memory problems appear. Know your blood pressure. Know your blood sugar and metabolic health. Don’t smoke,” Dr. Perlmutter says. “These aren’t exotic, expensive, or difficult interventions, and that’s precisely the point. Many of the most powerful tools we have for protecting the aging brain are available to each of us right now… This fundamentally changes the conversation from simply asking, ‘How can we treat Alzheimer’s?’ to asking, ‘How can we reduce the likelihood of getting there in the first place?’”
Taking these steps won’t just affect your dementia risk, either. “Smoking, diabetes, and blood pressure are clearly risk factors that would stop you from living a longer, generally healthier life—not just brain health, but overall body health,” says Jeremy M. Liff, M.D., board-certified neurologist based in New York City
And it’s never too early to make healthy changes. “Don’t wait until you’re in your mid-70s,” Dr. Liff urges. “One of the points of the study is they were looking at people in their 50s, so the time to start with this is now, because what you do now will have that downstream effect 20 to 40 years from now.”
Dr. Perlmutter agrees. “This fits perfectly with what we’re learning about Alzheimer’s disease. The biological changes that ultimately manifest as memory loss may be developing for 20 or even 30 years before the diagnosis,” he explains. “I think we’ve made a mistake by viewing Alzheimer’s simply as a disease of old age. Increasingly, we should think about it as a disease whose foundations may be laid in midlife or even earlier.”
How can you support your brain health?
Again, there’s no surefire way to avoid developing dementia or Alzheimer’s disease; as Dr. Liff notes, there are plenty of otherwise healthy patients who still develop it
Still, there are things you can do to support your brain health throughout your life. “I encourage people to think beyond any single supplement, food, drug, or ‘brain hack.’ Brain health reflects what we do consistently over many years,” Dr. Perlmutter says
In addition to monitoring your risk of developing diabetes or hypertension, and refraining from smoking, both Dr. Liff and Dr. Perlmutter recommend the following habits for good brain health:
Get regular exercise
Prioritize restorative sleep
Maintain meaningful social connections
Eat a minimally-processed diet rich in fiber and whole foods
Continue learning and challenging yourself
Protect your hearing
Avoid large amounts of alcohol
Avoid stimulants late at night
The bottom line
This study and others like it suggest we have more control over our dementia risk than we previously thought, but it’s important to keep these findings in context. Both Dr. Liff and Dr. Perlmutter point out that the research is observational, which means that while the studies found a clear association between vascular risk factors and dementia risk, they can’t establish a cause-and-effect relationship. Additionally, the researchers only assessed the participants for diabetes, hypertension, and smoking status at one point in midlife, rather than tracking the evolution of these risk factors over a longer period of time.
“And, of course, dementia is complicated. Genetics, environmental exposures, education, physical activity, social circumstances, and many other factors matter as well,” Dr. Perlmutter adds. “But again, many of these other factors reflect our lifestyle choices. And that gives each of us agency over our brain’s destiny.”
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