Profiles of lifestyle health behaviors and cognitive decline in older adults

Alzheimers Dement. 2024 Jan;20(1):472-482. doi: 10.1002/alz.13459. Epub 2023 Sep 7.


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.

MeSH terms

  • Aged
  • Cognition
  • Cognitive Dysfunction*
  • Health Behavior
  • Humans
  • Life Style
  • Neuropsychological Tests