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

Elena Lobo, Patricia Gracia-García, Antonio Lobo, Pedro Saz and Concepción De-la-Cámara
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Elena Lobo: Department of Preventive Medicine and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
Patricia Gracia-García: Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
Antonio Lobo: Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
Pedro Saz: Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
Concepción De-la-Cámara: Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain

IJERPH, 2021, vol. 18, issue 13, 1-13

Abstract: 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.

Keywords: aging; cognition; memory trajectories; ZARADEMP Study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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