Numerous lifestyle, cardiovascular, and psychosocial factors have been implicated in the development of cognitive decline and dementia. Using a person-centered approach, this study explored...Show moreNumerous lifestyle, cardiovascular, and psychosocial factors have been implicated in the development of cognitive decline and dementia. Using a person-centered approach, this study explored clustering of modifiable risk factors for cognitive decline and dementia and investigated how these clusters are associated with declines in cognition and with dementia risk. Here, cognitive decline was operationalized as declining information processing speed. The sample consisted of 3787 older adults (age 55-85) enrolled in the Longitudinal Aging Study Amsterdam. Latent class analysis was performed over a subset of 14 lifestyle, cardiovascular, and psychosocial risk factors to identify latent subgroups. Latent growth curve modelling associated membership in identified subgroups with trajectories of processing speed. Logistic regression associated group membership with incidence of probable dementia (n=2611). A four-class solution was deemed to optimally represent the sample. Next to a large group with no specific salient features (n=845, 75.1%), other groups reflected pronounced depressive symptoms (n=324, 8.6%), cardiometabolic risk (n=410, 10.8%), and high physical activity (n=208, 5.5%), respectively. Latent growth curve modeling suggested that declines in processing speed accelerated with age, but latent class membership did not seem to affect these declines. Compared to the normative group, the depressed group had lower initial levels of processing speed (β_intercept=-2.38; 95% CI=[-3.38, -1.37]; p<.001), but further trajectory differences between latent classes were not statistically significant at α=5%. No significant differences in odds of probable dementia between the normative and other groups were found. Thus, this study did not find evidence of an effect of membership in identified latent classes on the strength or rate of cognitive decline, nor dementia. To draw implications for clinical and political decision-making, future research could test the robustness of findings by replicating analyses in similar cohorts, examine the utility of other grouping structures, consider inclusion of alternative risk factors, and investigate auxiliary outcome measures of cognitive decline and dementia.Show less
