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. 2021 May 2;13(1):e12180.
doi: 10.1002/dad2.12180. eCollection 2021.

Trajectories of cognitive function in community-dwelling older adults: A longitudinal study of population heterogeneity

Zimu Wu  1 , Robyn L Woods  1 , Rory Wolfe  1 , Elsdon Storey  1 , Trevor T J Chong  2   3   4 , Raj C Shah  5 , Suzanne G Orchard  1 , John J McNeil  1 , Anne M Murray  6 , Joanne Ryan  1 ; ASPREE Investigator Group
Affiliations

Trajectories of cognitive function in community-dwelling older adults: A longitudinal study of population heterogeneity

Zimu Wu et al. Alzheimers Dement (Amst). .

Abstract

Introduction: This study aimed to investigate cognitive aging trajectories, the associated sociodemographic characteristics, and the association of these trajectories with dementia.

Methods: Generally healthy older adults (n = 19,114) were followed for up to 7 years, with regular cognitive assessments. Group-based trajectory modeling identified distinct cognitive trajectories.

Results: Four to seven trajectories were identified per cognitive domain. Stable trajectories were observed across domains. Improvement in verbal fluency and minor psychomotor slowing were common. Substantial decline in global cognition and episodic memory were observed in a small proportion of individuals. Older, less educated participants and men were more common in lower-functioning trajectories (p < .001). The highest proportions of dementia cases were in trajectories with major decline in global cognition (56.9%) and memory (33.2%).

Discussion: Inter-individual variability in cognitive trajectories was observed across all domains. Some individuals appear resilient to cognitive decline even with advancing age. Further research into factors promoting cognitive resilience is needed.

Keywords: cognitive function; dementia; longitudinal; older adults; prospective.

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Conflict of interest statement

Anne M. Murray reports receiving consulting fees from Alkahest, Inc. and grants from the National Institute on Aging. Raj C. Shah reports grants for clinical research regarding dementia and Alzheimer's disease from the National Institutes of Health, the Centers for Medicare and Medicaid Services, the Department of Defense, and the Illinois Department of Public Health; being a non‐compensated member of the Board of Directors of the Alzheimer's Association–Illinois Chapter; and being a site principal investigator or sub‐investigator for clinical trials and research studies for which his institution (Rush University Medical Center) is sponsored (Amylyx Pharmaceuticals, Inc.; Eli Lilly & Co., Inc.; Genentech, Inc.; Lundbeck, Inc.; Merck & Co, Inc.; Navidea Biopharmaceuticals; Novartis Pharmaceuticals, Inc.; Roche Holdings AG; and Takeda Development Center Americas, Inc.). Robyn L. Woods, Rory Wolfe, Elsdon Storey, Trevor T. J. Chong, John J. McNeil, and Suzanne G. Orchard report no competing interests.

Figures

FIGURE 1
FIGURE 1
Trajectory plots of individual cognitive tests (A) 3MS (n = 18,016), (B) COWAT‐F (n = 17,971), (C) HVLT‐R delayed recall (n = 17,837), (D) SDMT (n = 17,883). 3MS, modified Mini‐Mental State Examination; COWAT‐F, Controlled Oral Word Association Test‐F; HVLT‐R, Hopkins Verbal Learning Test–Revised (delayed recall); SDMT, Symbol Digit Modalities Test. Note: (1) The x‐axis denotes the year of cognitive assessments conducted at baseline as well as 1, 3, 4, 5, 6, and 7 years of follow‐up. The y‐axis denotes the raw scores of the cognitive tests. (2) The percentages refer to the proportions of participants assigned into the corresponding classes
FIGURE 2
FIGURE 2
Individual trajectories of individual cognitive tests by class: 3MS (n = 18,016), COWAT‐F (n = 17,971), HVLT‐R delayed recall (n = 17,837), SDMT (n = 17,883). 3MS, modified Mini‐Mental State Examination; COWAT‐F, Controlled Oral Word Association Test‐F; HVLT‐R, Hopkins Verbal Learning Test–Revised (delayed recall); SDMT, Symbol Digit Modalities Test. Note: (1) The x‐axis denotes the year of cognitive assessments conducted at baseline as well as 1, 3, 4, 5, 6, and 7 years of follow‐up. The y‐axis denotes the raw scores of the cognitive tests. (2) The percentages refer to the proportions of participants assigned into the corresponding classes. (3) Trajectories were generated by connecting the observed cognitive data at each timepoint
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References

    1. Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013;29(4):737‐752. - PMC - PubMed
    1. Wu Z, Phyo AZZ, Al‐harbi T, Woods RL, Ryan J. Distinct cognitive trajectories in late life and associated predictors and outcomes: a systematic review. J Alzheimers Dis Rep. 2020:459‐478. - PMC - PubMed
    1. Anstey KJ, Wood J. Chronological age and age‐related cognitive deficits are associated with an increase in multiple types of driving errors in late life. Neuropsychology. 2011;25(5):613‐621. - PubMed
    1. Peters R, Booth A, Rockwood K, Peters J, D'Este C, Anstey KJ. Combining modifiable risk factors and risk of dementia: a systematic review and meta‐analysis. BMJ Open. 2019;9(1):e022846. - PMC - PubMed
    1. Bellou V, Belbasis L, Tzoulaki I, Middleton LT, Ioannidis JPA, Evangelou E. Systematic evaluation of the associations between environmental risk factors and dementia: an umbrella review of systematic reviews and meta‐analyses. Alzheimer's Dement. 2017;13(4):406‐418. - PubMed

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