Profiles of lifestyle health behaviors and cognitive decline in older adults

Abstract

Introduction: We aimed to identify profiles of modifiable, late-life lifestyle health behaviors related to subsequent maintenance of cognition and explore sociodemographics and health characteristics as effect modifiers.

Methods: Analyses used data from 715 older adults without baseline dementia from the Rush Memory and Aging Project and with lifestyle health behaviors (physical activity, cognitive activity, healthy diet, social activity) at baseline and ≥ 2 annual assessments of cognition. We used latent profile analysis to group participants based on behavior patterns and assessed change in cognition by group.

Results: Three latent profiles were identified: high (n = 183), moderate (n = 441), and low (n = 91) engagement in health behaviors. Compared to high engagement, the moderate (mean difference [MD] = -0.02, 95% CI = [-0.03;-0.0002], p = 0.048) and low (MD = -0.06, 95% CI = [-0.08;-0.03], p < 0.0001) groups had faster annual rates of decline in global cognition, with no significant effects modifiers (vascular risk factors, apolipoprotein E [APOE] ε4, motor function).

Discussion: Avoiding low levels of lifestyle health behaviors may help maintain cognition.

Highlights: Latent profile analysis (LPA) captures lifestyle health behaviors associated with cognitive function. Such behavior include physical activity, cognitive activity, healthy diet, social activity. We used LPA to examine associations of behaviors and cognitive function over time. Older adults with low lifestyle health behaviors showed more rapid decline. To a lesser degree, so did those with moderate lifestyle health behaviors. Vascular conditions and risks, APOEε4, or motor function did not modify the effect.

Keywords: cognitive decline; latent profile analysis; lifestyle behaviors; longitudinal study; neuropsychological tests.

FIGURE 1

Mean standardized values and 95% confidence intervals of lifestyle health behaviors in the three selected profiles of engagement at baseline (A) and individual observed trajectories of global cognition during follow‐up for 25 participants randomly selected in each profile (B), Memory and Aging Project.

FIGURE 2

Estimated mean trajectories of global cognition among participants with high (n = 183), moderate (n = 441), and low (n = 91) engagement in healthy lifestyle behaviors at baseline, Memory and Aging Project. Trajectories were plotted for the most common profile of covariates in the study sample (i.e., female, 81 years of age at analytical baseline, 15 years of education, a score of 1 for vascular disease risk factors [average of 3 items], a score of 0.3 for vascular disease burden [average of 4 items], and a score of 1 for motor function). Shading represents the 95% confidence intervals.