���ϸ�����

As the founding director of ���ϸ����� Langone Health’s , , is charged with advancing the science of aging to improve health and prolong lives. If that sounds ambitious, it is in fact an extension of his work during the past 30 years. An internationally recognized expert on vascular, brain, and kidney health in older adults, Dr. Coresh has played a leading role on the , one of the longest-running heart health studies in the world. The Terry and Mel Karmazin Professor of and a professor in the , Dr. Coresh has published a remarkable 1,000-plus scientific papers and continues to break new ground. In January 2025, he and his team made headlines with a that found the risk of developing dementia to be more than twice as high as previous estimates. We spoke with Dr. Coresh about his research, the institute’s work, and what we can all do to reduce the toll of aging on our bodies and minds.

Optimal aging sounds like a contradiction. How can a stage of life associated with decline be “optimized”?

We need to change the notion that aging is synonymous with decline. Things like wisdom, experience, social networks, and financial capital, for instance, tend to increase with age. The central tenet of the institute is that we can optimize each stage of our later lives, retaining as much independence, functionality, and joy as possible.

Why has ���ϸ����� Langone chosen to establish this institute now, and what is its focus?

By 2034, the number of Americans over 65 will surpass the number under 18 for the first time. While aging is inevitable, our view is that many of its worst consequences can be prevented. The institute’s goal is to identify the core mechanisms underlying optimal health and how they go awry with aging, and to translate those insights to help people live longer, healthier lives. We’re building a hub that connects world-leading, cross-disciplinary teams of scientists and clinicians who will generate, share, and leverage resources. We aim to become an incubator, fueling research that informs risk factor prediction, prevention strategies, diagnostics, therapeutic interventions, and policy changes.

What are the institute’s primary research interests?

For starters, we’re focusing on vascular health, brain health, kidney health, and sensory impairment. Epidemiology, the study of how diseases spread and affect populations, is at our core, but we’re connecting it with new developments in laboratory science, wearable devices, and artificial intelligence (AI). For instance, we’re using Fitbit devices to track the movements and sleep patterns of adults ages 80 to 100 who are part of the ARIC-NCS study. We’re harnessing machine learning to probe electronic medical records. We’re collaborating with precision medicine experts to analyze blood and tissue samples on a molecular level, studying genomes, proteins connected to disease, and metabolites, the small molecules within cells and tissues. We’re analyzing a broad spectrum of clinical trials, and we’re working to see how the patterns in all this data connect to disease and provide clues for treatment.

You had a distinguished career at Johns Hopkins University. What compelled you to join ���ϸ����� Langone?

���ϸ����� Langone offered the opportunity to work within a fully integrated healthcare system. When we’re recruiting people to look at, say, hearing loss, we can have them work directly with otolaryngologists and audiologists on clinical applications. I collaborate with leaders across both the basic science and clinical divisions. Plus, ���ϸ����� Langone is a national leader in so many relevant areas of patient care, from cardiology to endocrinology to neurology.

Your recent study projects a somber outlook: the risk of Americans developing dementia—a condition characterized by progressive declines in memory, concentration, and judgment—after age 55 is 42 percent, and dementia cases will double by 2060. Why were previous estimates so much lower?

Our study encompassed four decades of research on 15,000 patients, representing a larger, more diverse population and incorporating updated information about overall health and longevity. Our risk estimate translates into 500,000 new cases this year, rising to 1 million annually by 2060. By then, 12 million people in the United States will have dementia, placing a huge burden on society. We need to prepare for that as soon as possible.

Is there any good news to report?

Absolutely! A 42 percent lifetime risk means that if you’re 55, your risk by age 75 is only 4 percent. The steep rise happens after 85, when more than half of the dementia risk occurs. So you’ve got plenty of time to work on lowering your risk. Research shows that about half of the risk factors for dementia are modifiable.

What can people do to lower their risk?

One useful set of guidelines I recommend is , a checklist of critical health behaviors from the American Heart Association: eat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood sugar, and manage blood pressure. Though the list is aimed at promoting cardiovascular health, these tips can help ward off dementia, as well. The Lancet Commission on dementia prevention, intervention, and care expands the list to 14 modifiable risk factors, including social isolation and hearing and vision loss.

What’s the connection between vascular health and dementia?

Put simply, vascular disease reduces blood flow to important brain regions. Beyond this, our research has found that people ages 40 to 60 with midlife vascular risk factors tend to have greater amounts of amyloid plaque, abnormal brain proteins thought to be a key driver of Alzheimer’s disease. Further research is needed to quantify the best strategies and timing relating vascular risk treatment to reducing dementia risk and brain plaque buildup.

What about hearing loss?

A study I coauthored found that hearing loss is a risk factor for dementia and that hearing aids slow its progression among people at high risk. One explanation is that hearing loss can lead to social isolation and depression, both risk factors for dementia. Another is that hearing impairment increases cognitive load in a harmful way. If you’ve ever tried holding a conversation at a noisy rock concert, you know how challenging it is. If you did that constantly for years, your brain might rewire itself to the point where you’d have cognitive problems.

What are your priorities in the next year or two?

Our next initiative is to expand our research on sensory health and translate it into interventions that delay cognitive decline and improve older adults’ quality of life. We are continuing to recruit excellent faculty. We’re searching for biomarkers of brain health, with the goal of developing blood tests for Alzheimer’s and other forms of dementia. And we plan to use wearables to drive behavior change and provide actionable
patient data.

What’s the most important lesson you’d like people to know about aging well?

Research and technology are providing promising progress with multiple additional tools. However, there is no single high-tech fix or miracle supplement on the horizon. Living optimally requires effort and balance, and you’ve got to keep it up for decades.