A Subtype Perspective on Cognitive Trajectories in Healthy Aging

Abstract

Cognitive aging is a complex and dynamic process characterized by changes due to genetics and environmental factors, including lifestyle choices and environmental exposure, which contribute to the heterogeneity observed in cognitive outcomes. This heterogeneity is particularly pronounced among older adults, with some individuals maintaining stable cognitive function while others experience complex, non-linear changes, making it difficult to identify meaningful decline accurately. Current research methods range from population-level modeling to individual-specific assessments. In this work, we review these methodologies and propose that population subtyping should be considered as a viable alternative. This approach relies on early individual-specific detection methods that can lead to an improved understanding of changes in individual cognitive trajectories. The improved understanding of cognitive trajectories through population subtyping can lead to the identification of meaningful changes and the determination of timely, effective interventions. This approach can aid in informing policy decisions and in developing targeted interventions that promote cognitive health, ultimately contributing to a more personalized understanding of the aging process within society and reducing the burden on healthcare systems.

Association of a pace of aging epigenetic clock with rate of cognitive decline in the Framingham Heart Study Offspring Cohort

“…In observational cohort studies, the rate of preclinical cognitive decline varies, with some individuals maintaining healthy cognitive function for many years while others decline rapidly to ADRD onset 7,8 . Better understanding of the causes of this variation are needed to inform risk stratification in clinical trials and improve prognosis in clinical care 9 . Here we test the geroscience-informed hypothesis that some individuals experience more rapid preclinical cognitive decline than others because they have a faster pace of biological aging.…”