{"title":"Group-based trajectory modelling for cognitive changes in middle-aged and older adults: A systematic review","authors":"Huan Zhang , Hongli Chen , Xiaotong Ding , Qing Wang , Jingjing Gu , Shuaifang Wei , Jiajun Xue , Yulin Liang , Zheng Li","doi":"10.1016/j.arr.2025.102855","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Cognitive health constitutes a critical component of healthy aging. This study aims to review studies that employed group-based trajectory modeling approaches systematically to examine cognitive trajectories, identify associated determinants, and investigate the relationship with health outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was performed in five databases for articles that identified two or more cognitive trajectories. The study was conducted following the PRISMA statement.</div></div><div><h3>Results</h3><div>Thirty-five studies, published from 2007 to 2024 across multiple countries, with sample sizes ranging from 318 to 19422 participants, were ultimately included in this study. The “High Stable” and “Moderate Decline” trajectories were the most frequently observed patterns. Key protective factors associated with the stable group included higher education, active lifestyle (e.g., cognitive/physical activities, high quality and appropriate duration of sleep, no smoking), and strong social networks. Older people with cardiovascular diseases, diabetes, and depression tend to experience rapid cognitive decline. Although relatively few studies have focused on biomarkers and brain structural changes, available evidence suggests that factors such as APOE ε4 carriage higher Aβ/global amyloid load, elevated t-tau+ , and entorhinal cortical thinning are associated with cognitive decline trajectories. In addition, several studies highlighted significant consequences linked to rapid cognitive deterioration, such as high incidence of dementia, mortality, and disability.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of aging individuals maintain cognitive function over time, which may be supported by protective strategies like cognitive/physical engagement, healthy sleep, social connection, and disease management. The adverse outcomes linked to decline trajectories underscore the need for future research on modifiable factors. Comparing predictors across subgroups provides insights into cognitive resilience and proactive protection. Further exploration of biological measures is crucial for understanding cognitive aging and enabling earlier dementia prevention.</div></div>","PeriodicalId":55545,"journal":{"name":"Ageing Research Reviews","volume":"112 ","pages":"Article 102855"},"PeriodicalIF":12.4000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ageing Research Reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1568163725002016","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CELL BIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Cognitive health constitutes a critical component of healthy aging. This study aims to review studies that employed group-based trajectory modeling approaches systematically to examine cognitive trajectories, identify associated determinants, and investigate the relationship with health outcomes.
Methods
A systematic search was performed in five databases for articles that identified two or more cognitive trajectories. The study was conducted following the PRISMA statement.
Results
Thirty-five studies, published from 2007 to 2024 across multiple countries, with sample sizes ranging from 318 to 19422 participants, were ultimately included in this study. The “High Stable” and “Moderate Decline” trajectories were the most frequently observed patterns. Key protective factors associated with the stable group included higher education, active lifestyle (e.g., cognitive/physical activities, high quality and appropriate duration of sleep, no smoking), and strong social networks. Older people with cardiovascular diseases, diabetes, and depression tend to experience rapid cognitive decline. Although relatively few studies have focused on biomarkers and brain structural changes, available evidence suggests that factors such as APOE ε4 carriage higher Aβ/global amyloid load, elevated t-tau+ , and entorhinal cortical thinning are associated with cognitive decline trajectories. In addition, several studies highlighted significant consequences linked to rapid cognitive deterioration, such as high incidence of dementia, mortality, and disability.
Conclusion
A substantial proportion of aging individuals maintain cognitive function over time, which may be supported by protective strategies like cognitive/physical engagement, healthy sleep, social connection, and disease management. The adverse outcomes linked to decline trajectories underscore the need for future research on modifiable factors. Comparing predictors across subgroups provides insights into cognitive resilience and proactive protection. Further exploration of biological measures is crucial for understanding cognitive aging and enabling earlier dementia prevention.
期刊介绍:
With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends.
ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research.
The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.