Group-based trajectory modelling for cognitive changes in middle-aged and older adults: A systematic review

Area of Science:

• Gerontology
• Neuroscience
• Public Health

Background:

• Cognitive health is essential for successful aging.
• Understanding cognitive trajectories and their determinants is crucial.

Purpose of the Study:

• Systematically review studies using group-based trajectory modeling for cognitive trajectories.
• Identify factors influencing cognitive trajectories.
• Investigate the relationship between cognitive trajectories and health outcomes.

Main Methods:

• Systematic literature search across five databases.
• Included studies identified two or more distinct cognitive trajectories.
• Adhered to the PRISMA statement for systematic reviews.

Main Results:

• Thirty-five studies (2007-2024) with 318-19422 participants were analyzed.
• "High Stable" and "Moderate Decline" were the most common cognitive trajectories.
• Protective factors for stable cognition include education, active lifestyle, good sleep, and social networks. Cardiovascular diseases, diabetes, and depression are linked to decline. Biomarkers like APOE ε4, amyloid load, and tau are associated with decline. Rapid decline correlates with increased dementia, mortality, and disability.

Conclusions:

• A significant portion of aging individuals exhibit stable cognitive function, supported by lifestyle factors and disease management.
• Adverse outcomes of cognitive decline emphasize the need for research on modifiable factors.
• Further research into biological markers is vital for understanding cognitive aging and dementia prevention.