Differences in Trajectories and Predictive Factors of Cognition over Time in a Sample of Cognitively Healthy Adults, in Zaragoza, Spain

Great inter-individual variability has been reported in the maintenance of cognitive function in aging. We examined this heterogeneity by modeling cognitive trajectories in a population-based longitudinal study of adults aged 55+ years. We hypothesized that (1) distinct classes of cognitive trajecto...

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Bibliographic Details
Published in:International journal of environmental research and public health 2021-07, Vol.18 (13), p.7092
Main Authors: Lobo, Elena, Gracia-García, Patricia, Lobo, Antonio, Saz, Pedro, De-la-Cámara, Concepción
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adult
Adults
Age
Aging
Anxiety
Cognition
Cognition & reasoning
Cognitive ability
Cognitive Dysfunction - epidemiology
Cognitive tasks
Dementia
Dementia disorders
Education
Geriatrics
Health care
Heterogeneity
Humans
Longitudinal Studies
Memory
Mental Status and Dementia Tests
Older people
Population studies
Questionnaires
Spain - epidemiology
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Summary:Great inter-individual variability has been reported in the maintenance of cognitive function in aging. We examined this heterogeneity by modeling cognitive trajectories in a population-based longitudinal study of adults aged 55+ years. We hypothesized that (1) distinct classes of cognitive trajectories would be found, and (2) between-class differences in associated factors would be observed. The sample comprised 2403 cognitively healthy individuals from the Zaragoza Dementia and Depression (ZARADEMP) project, who had at least three measurements of the Mini-Mental State Examination (MMSE) in a 12-year follow-up. Longitudinal changes in cognitive functioning were modeled using growth mixture models (GMM) in the data. The best-fitting age-adjusted model showed 3 distinct trajectories, with 1-high-to-moderate (21.2% of participants), 2-moderate-stable (67.5%) and, 3-low-and-declining (9.9%) cognitive function over time, respectively. Compared with the reference 2-trajectory, the association of education and depression was significantly different in trajectories 1 and 3. Instrumental activities of daily living (iADLs) were only associated with the declining trajectory. This suggests that intervention strategies should be tailored specifically to individuals with different trajectories of cognitive aging, and intervention strategies designed to maintain cognitive function might be different from those to prevent decline. A stable cognitive performance ('successful cognitive aging') rather than a mild decline, might be more 'normal' than generally expected.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph18137092