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Clinical Manifestations.

Melisa Lara Gomez1, Phoebe Scollard2, Sarah Biber3

  • 1Vanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

This study identified four distinct cognitive decline trajectories in older adults, including non-decliners and varying rates of decline. These patterns are linked to demographic and clinical factors, offering insights into cognitive aging.

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Area of Science:

  • Cognitive neuroscience
  • Gerontology
  • Biostatistics

Background:

  • Late-life cognitive trajectories show significant individual variability across different cognitive domains.
  • Understanding this heterogeneity is crucial for effective cognitive aging research and interventions.

Purpose of the Study:

  • To identify distinct latent classes of cognitive trajectories in memory, executive function, and language.
  • To examine the association between these identified cognitive trajectories and baseline demographic and clinical characteristics.

Main Methods:

  • Utilized harmonized data from 14 longitudinal cognitive aging and dementia cohorts.
  • Developed latent class linear mixed models to analyze cognitive domains (memory, executive function, language) as linear and quadratic functions of age.
  • Assessed model fit using standard metrics and compared baseline variables across identified classes.

Main Results:

  • A 4-class model best represented cognitive trajectories: non-decliners, slow decliners, steady decliners, and rapid decliners.
  • Memory trajectories showed distinct patterns compared to executive function and language, particularly in the rapid decliner group.
  • Specific demographic and clinical factors, including race, cognitive status, and APOE genotype, were associated with different decline trajectories.

Conclusions:

  • Latent class analysis reveals distinct subgroups of cognitive decline, varying in timing and rate, from normal cognition to dementia.
  • Further research is needed to integrate disease progression timelines, confirm subgroup stability, and explore underlying neuropathological and neuroimaging correlates.