Potential modifiable factors associated with late-life cognitive trajectories

Area of Science:

• Gerontology
• Neuroscience
• Public Health

Background:

• Cognitive aging exhibits significant individual variability.
• Understanding modifiable factors influencing cognitive trajectories is crucial for public health interventions.

Purpose of the Study:

• To investigate the associations between modifiable lifestyle and health factors and distinct cognitive aging trajectories.
• To differentiate factors associated with high versus low cognitive performance.

Main Methods:

• Utilized data from 17,724 community-dwelling older adults (aged 65-98).
• Employed group-based multi-trajectory modeling to identify cognitive trajectories over seven years.
• Applied structural equation modeling to assess associations of social, behavioral, and health factors with cognitive trajectories.

Main Results:

• Seven distinct cognitive trajectory subgroups were identified.
• Lower education, never drinking alcohol, and frailty were direct predictors of low cognitive performance.
• Hypertension, obesity, diabetes, and depression were associated with a lower likelihood of high cognitive performance, while dyslipidemia was linked to low performance.
• Smoking did not directly predict cognitive trajectories but was associated with increased risk of diabetes, obesity, and frailty.

Conclusions:

• Several modifiable factors are associated with high cognitive performance and inversely with low performance.
• Obesity, hypertension, and dyslipidemia showed less direct association with cognitive trajectories.
• Health behaviors may influence cognitive function indirectly through geriatric conditions, suggesting distinct strategies for cognitive health promotion and dementia prevention.