A systematic review of multivariate studies in cognitive aging: Introducing the concept of cognitive organization

Despite ample research on cognitive aging, it is still largely unknown whether cognition is organized in a distinct manner, with different cognitive domains and subcomponents interrelating with each other. It is also unknown whether this cognitive organization is stable or changes with increasing age. Following the PRISMA guidelines statement, we conducted a systematic review of multivariate studies of cognitive aging with the aim to identify a potential cognitive organization in healthy aging. We consulted Embase, PsycInfo and Medline electronic databases from 2000 to October 2025. The methodological quality of the included studies was analysed using CASP tools and a narrative synthesis of the selected articles was performed. We screened 1518 references and a total of 14 research articles met selection criteria and were included. We found convergent findings across studies suggesting a cognitive organization of four factors: memory, language, executive functions, and processing speed. This cognitive organization was rather consistent across studies, cohorts, and methodologies. A fifth factor for visuospatial abilities was identified in several studies. Some studies reported that processing speed may influence age-related changes in the direct performance of other cognitive domains. However, the current evidence did not allow concluding on the effect of age in this cognitive organization. Therefore, it is yet to be clarified whether this cognitive organization remains invariant throughout age. Advancing in our understanding of cognitive aging can result in a more accurate and personalized clinical assessment and intervention in people at risk of cognitive impairment.