Dementia risk factors, everyday functioning, and healthy aging across cognitive status

Reviews enumerate several modifiable risk factors that offer avenues for early intervention across midlife and older adulthood. The current study examined the relationship between risk factors and cognitive status (i.e., healthy older adults [HOA], subjective cognitive decline [SCD], and mild cognitive impairment [MCI]), and their association with everyday functioning and engagement in healthy aging behaviors.

Participants were 260 community-dwelling midlife and older adults. They completed clinical interviews and self-report questionnaires assessing healthy aging activity engagement and everyday functioning cross-sectionally. Dementia risk variables were dichotomized and weighted using the relative risk value from the Lancet Commission to create a composite dementia risk score.

Analysis of variance revealed significant group differences in dementia risk, F(2, 257) = 5.90, p = .003, η2 = 0.04, with significantly lower risk in HOA than both SCD and MCI. Hierarchical regressions found that the dementia risk score significantly associated with everyday functioning above and beyond global cognition and age. After controlling for cognition and age, dementia risk is also associated with engagement in healthy aging behaviors and their subtypes (i.e., biological health, social and cognitive strategies, health safeguard behaviors). Exploratory analyses of individual risk factors identified specific predictors of everyday functioning and healthy aging engagement.

These findings establish overlapping risk profiles and vulnerabilities for both SCD and MCI groups. Findings support both biological and mental health factors associated with everyday functioning and healthy aging activities, highlighting the importance of early intervention and a proactive, individualized approach to manage dementia risk across the lifespan.