Midlife Diabetes and Hypertension May Accelerate Dementia Risk
Midlife diabetes and hypertension together raise dementia risk, especially among Black Americans.
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A new study from the University of Georgia suggests that the combination of diabetes and hypertension in midlife may increase the risk of developing dementia-related brain changes more than a decade later, particularly among Black Americans.
Hypertension
A chronic condition in which the force of blood against artery walls is consistently too high, increasing the risk of heart disease, stroke and other health issues.Researchers found that individuals diagnosed with both conditions during midlife exhibited significantly elevated levels of a biomarker associated with dementia, compared to those with either condition alone. The study followed more than 250 adults over an 11-year period and measured neurological outcomes linked to cognitive decline.
Biomarker
A measurable indicator of a biological condition or disease. In this study, it refers to a substance linked with dementia risk.Cognitive decline
The gradual loss of cognitive functions such as memory, decision-making and attention, often associated with aging or neurological disorders.Compounding health conditions and long-term brain impact
While either diabetes or hypertension alone was not strongly associated with increases in the dementia-related biomarker, the presence of both conditions had a cumulative effect. Participants with both conditions showed not only higher baseline levels of the biomarker but also a greater increase over time, suggesting a compounding impact on brain health.
"This study shows that chronic conditions like high blood pressure and diabetes, especially when combined together, might start damaging the brain earlier than we thought, especially for this group.”
Dr. Rachael Weaver.
The biomarker, which was not named in the study summary, is recognized in neuroscience research as an indicator of risk for neurodegenerative diseases.
Neurodegenerative disease
A type of condition involving the progressive loss of structure or function of neurons, including diseases such as Alzheimer’s and Parkinson’s.Cardiovascular health and disparities in cognitive decline
The findings provide additional insight into known disparities in dementia incidence. Black Americans, on average, experience cognitive decline at earlier ages and at higher rates than white populations. This study supports the growing understanding that vascular health plays a significant role in brain aging and highlights midlife as a critical window for intervention.
"Taking steps early to control high blood pressure and diabetes may help protect African Americans from brain degeneration and lower their risk of dementia.”
Dr. Karlo Lei.
Socioeconomic factors also featured prominently in the participant group. Many individuals reported low incomes, and nearly 20% had not completed high school. These findings underscore how structural inequities may compound biological risk factors, influencing long-term cognitive outcomes.
Early prevention strategies and community health education
The authors recommend that clinicians and public health professionals increase attention to cardiovascular health during midlife, especially in communities at higher risk of cognitive decline. Early detection and management of hypertension and diabetes may serve as an important strategy to mitigate future dementia risk.
The researchers also emphasize the importance of culturally and socioeconomically sensitive public health education to address underlying systemic disparities. Preventative health behaviors such as physical activity, stress management, improved diet and reduced tobacco and alcohol use may support both heart and brain health.
Reference: Simons RL, Ong ML, Lei MK, et al. Diabetes and hypertension at midlife predict increases in biomarkers of dementia among black Americans. J Racial and Ethnic Health Disparities. 2025. doi: 10.1007/s40615-025-02310-2
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