Association Between Cognitive Trajectories and Subsequent Health Status, Depressive Symptoms, and Mortality Among Older Adults in the United States: Findings From a Nationally Representative Study

Emma Zang, Yunxuan Zhang, Yi Wang, Bei Wu, Terri R. Fried, Robert D. Becher, Thomas M. Gill

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Cognitive decline may be an early indicator of major health issues in older adults, though research using population-based data is lacking. Researchers objective was to assess the relationships between distinct cognitive trajectories and subsequent health outcomes, including health status, depressive symptoms, and mortality, using a nationally representative cohort. Methods: Data were drawn from the National Health and AgingTrends Study. Global cognition was assessed annually between 2011 and 2018. The health status of 4413 people, depressive symptoms in 4342 individuals, and deaths among 5955 living respondents were measured in 2019. Distinct cognitive trajectory groups were identified using an innovative Bayesian group-based trajectory model. Ordinal logistic, Poisson, and logistic regression models were used to examine the associations between cognitive trajectories and subsequent health outcomes. Results: Researchers identified five cognitive trajectory groups with distinct baseline values and subsequent changes in cognitive function. Compared with the group with stably high cognitive function, worse cognitive trajectories (ie, lower baseline values and sharper declines) were associated with higher risks of poor health status, depressive symptoms, and mortality, even after adjusting for relevant covariates. Conclusions: Among older adults, worse cognitive trajectories are strongly associated with subsequent poor health status, high depressive symptoms, and high mortality risks. Regular screening of cognitive function may help to facilitate early identification and interventions for older adults susceptible to adverse health outcomes.

Original languageEnglish (US)
Article numberglae143
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume79
Issue number8
DOIs
StatePublished - Aug 1 2024

Keywords

  • Cognitive functioning
  • Depressive symptoms
  • Health status
  • Mortality
  • Trajectory analyses

ASJC Scopus subject areas

  • General Medicine

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