Trajectories of social health, cognitive, and daily functioning in community-dwelling older adults

Anna Marseglia; Eline Verspoor; Marieke Perry; Myrra Vernooij-Dassen; Jeannie-Marie S Leoutsakos; Henry Brodaty; Jean Stafford; Mohammad Arfan Ikram; Joanna Rymaszewska; Anna-Karin Welmer; Karin Wolf-Ostermann; Frank J Wolters; Amaia Calderón-Larrañaga; René J F Melis; SHARED Consortium

doi:10.1093/geroni/igag010

Trajectories of social health, cognitive, and daily functioning in community-dwelling older adults

Innov Aging. 2026 Feb 3;10(5):igag010. doi: 10.1093/geroni/igag010. eCollection 2026.

Authors

Anna Marseglia¹, Eline Verspoor², Marieke Perry^{2

3}, Myrra Vernooij-Dassen⁴, Jeannie-Marie S Leoutsakos^{5

6}, Henry Brodaty⁷, Jean Stafford⁸, Mohammad Arfan Ikram⁹, Joanna Rymaszewska¹⁰, Anna-Karin Welmer^{11

12}, Karin Wolf-Ostermann¹³, Frank J Wolters^{9

14}, Amaia Calderón-Larrañaga^{11

15}, René J F Melis²; SHARED Consortium

Affiliations

¹ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
² Department of Geriatrics, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
³ Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴ Department IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands.
⁵ Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
⁶ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.
⁷ Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁸ MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, United Kingdom.
⁹ Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
¹⁰ Department of Clinical Neuroscience, Faculty of Medicine, Wroclaw University of Science and Technology, Wrocław, Poland.
¹¹ Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
¹² Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
¹³ Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany.
¹⁴ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
¹⁵ Stockholm Gerontology Research Center, Stockholm, Sweden.

Abstract

Background and objectives: Cognitive and functional impairments can both influence and result from deteriorating social health (SH), yet their interplay during aging remains poorly understood. This study investigated the concordance and discordance of trajectories in SH, cognitive, and daily functioning.

Research design and methods: We analyzed 15-year follow-up data (2001-2015) from 2,848 initially dementia-free older adults in the Swedish National study on Aging and Care in Kungsholmen. Cognition and daily functioning were assessed with the Mini-Mental State Examination and activities of daily living (ADLs)/instrumental ADLs. SH encompassed indices of social participation, connections, and support. Trajectories across these five dimensions were identified using latent growth curve analyses, latent class growth analyses, and growth mixture models.

Results: Two cognitive trajectories-relatively preserved (91%) and fast decline (9%)-and two daily functioning trajectories-stable (95%) and declining (5%)-were identified. SH trajectories included stable groups, gradually declining social participation (70%), and low initial social connections (29%). Social support showed stable (95%), declining (2%), and increasing (3%) trajectories. Women were more likely to belong to the initially low-stable social connections group, whereas higher education was linked to favorable trajectories across most dimensions but not social support. Concordance was observed among those with the lowest cognitive, daily functioning, and SH profiles. Notably, increasing social support was linked to low cognition but high daily functioning (odds ratios [OR] = 4.2, 95% CI: 2.3, 7.6).

Discussion and implications: Findings underscore the central role of SH in aging, particularly how dynamic changes in social participation, connections, and support relate to cognitive and functional outcomes.

Keywords: Cognition; Cohort study; Daily functioning; Latent class growth analysis; Latent growth curve analysis; Social health.