Seven-Year Cognitive Trajectories in Older Adult Cancer Survivors: Findings From a National Cohort Study

To describe the long-term trajectories of cognitive impairment in older adult cancer survivors and to identify factors associated with distinct trajectories.

Data were sourced from the National Health and Aging Trends Study (2015-2021), a nationally representative cohort study of community-dwelling older adults aged 65 years or older.

Cognitive function was assessed annually with self-reported diagnoses and cognitive function tests. Group-based trajectory models were used to identify cognitive trajectories, and multinomial logistic regression models were used to examine associations between baseline characteristics and trajectory affiliations.

1,564 older adults with cancer and 3,447 without cancer were included. Four trajectories of cognitive impairment were identified: low-stable (64%), low-slowly deteriorating (18%), low-rapidly deteriorating (6%), and persistent-high (12%). Older age, lower education and income levels, poorer self-rated health, physical frailty, and comorbidities were significantly associated with persistent-high or deteriorating trajectories (p < 0.05).

The current study highlights the specific dynamic features of cognitive decline among older adult cancer survivors and identifies risk factors for early identification of patients at high risk for less favorable trajectories.