Psychological profiles associated with mental, cognitive and brain health in middle-aged and older adults

Psychological characteristics are associated with varying dementia risk and protective factors. To determine whether these characteristics aggregate into psychological profiles and whether these profiles differentially relate to aging health, we conducted a cross-sectional investigation in two independent middle-aged (51.4 ± 7.0 years (mean ± s.d.); N = 750) and older adult (71.1 ± 5.9 years; N = 282) cohorts, supplemented by longitudinal analyses in the former. Using a person-centered approach, three profiles emerged in both cohorts: those with low protective characteristics (profile 1), high risk characteristics (profile 2) and well-balanced characteristics (profile 3). Profile 1 showed the worst objective cognition in older age and middle age (at follow-up), and most rapid cortical thinning. Profile 2 exhibited the worst mental health symptomology and lowest sleep quality in both older age and middle age. We identified profile-dependent divergent patterns of associations that may suggest two distinct paths for mental, cognitive and brain health, emphasizing the need for comprehensive psychological assessments in dementia prevention research to identify groups for more personalized behavior-change strategies. This cross-sectional study in two independent middle-aged and aged cohorts investigates whether psychological characteristics associated with varying dementia risk aggregate into psychological profiles and relate to aging brain health.