Aging in cognitively healthy italian elders using multi-trajectories

Abstract

Introduction. Much less is known about the trajectories of cognitive health, physical functioning, and disability in elderly people without a diagnosis of dementia. Objective. The aims of this study were to identify the multi-trajectory trends of cognitive health, physical functioning, and disability in non-demented elderly people living in Abbiategrasso (Milan) and to explore the aging profiles in different trajectories. Materials and Methods. Data were retrieved from the ongoing prospective population-based study "InveCeAb," started in 2010. This analysis included only 993 people who attended at least one of the two follow-ups and were without dementia at baseline. The outcomes evaluated were cognitive impairment using the Mini Mental State Examination, disability using six items from the Basic Activities of Daily Living score, and physical functioning through a walking test. The trajectories were analyzed using group-based trajectory models. The identified profiles were explored with a multinomial logistic regression considering gender, age at baseline, presence of the ApoE-4 allele, educational level, and obesity. Results. One group showed the best trend in all outcomes over time and included the largest number of elderly individuals (n = 703). The second group (n = 253) showed an "intermediate" trend with a decline in cognition but a constant walking speed. The last group displayed a strong decline in cognitive function, an increase in the time to complete the walking test, and multiple difficulties in daily living activities. The profiles of the elderly in the three groups differed in terms of age, gender, educational level, and obesity. Conclusions. This finding is consistent with published evidence on the relationship between obesity and cognitive health decline.