Dementia is a serious global health concern. It affects more than 57 million people worldwide, according to the World Health Organization, and is the seventh leading cause of death. In the U.S., 42% of Americans are at risk of developing dementia after age 55, a 2025 study found.
Health and behavior across the entire lifespan contribute to a person’s risk of eventually developing dementia. But the new findings suggest there are still opportunities in midlife to prevent or delay its onset, says Coresh. In your 40s, 50s, and 60s, “you have the potential to continue to reduce the risk” of cognitive decline and possibly gain more years living without dementia.
The researchers found that people without these risk factors who hadn’t developed dementia went on to live nearly 13 years longer than those who smoked, had high blood pressure, and also had diabetes. “Each additional risk factor in midlife was associated with fewer expected years alive and free of dementia,” Dr. Jordan Weiss, an assistant professor at the Optimal Aging Institute at NYU Langone and study author, wrote in an email.
The research does not prove that these three risk factors caused dementia—only that there is an association between not having them and living longer without the condition. Risk factor measurement was also only performed once, at the study’s onset, and doesn’t account for other lifestyle habits or behaviors during those 20 or so years. ”We don't capture worsening over time, or smoking cessation, for example,” wrote Weiss.
Other modifiable risk factors for dementia
“We’ve really found—over the last decade, even—an accumulation of many, many risk factors for dementia,” says Dr. Jeffrey Kaye, a professor of neurology and biomedical engineering at Oregon Health & Science University and director of the Layton Aging and Alzheimer’s Disease Center (who wasn't involved in the new study).
Some dementia cases can’t be prevented, however. Age, for example, is the single greatest risk factor: About one in 13 people from ages 65 to 84 have Alzheimer’s disease. Among people 85 and older, that rises to about one in three. A person’s genes, race, and gender also influence their odds of having dementia.
But this latest research underscores the thinking that behavior and overall health impact your brain with age, and dementia isn’t an inevitable part of getting older. “Trying to mitigate the risks of having certain conditions or health practices is really important,” says Kaye.
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