Subgroups in Late Adulthood Are Associated With Cognition and Wellbeing Later in Life.

Tulsi A Radhoe,Hilde M Geurts,Almar A L Kok,Joost A Agelink Van Rentergem,Martijn Huisman

doi:10.3389/fpsyg.2021.780575

Abstract

Objectives: In this study, we aim to discover whether there are valid subgroups in aging that are defined by modifiable factors and are determinant of clinically relevant outcomes regarding healthy aging.Method: Data from interviews were collected in the Longitudinal Aging Study Amsterdam at two measurement occasions with a 3-year interval. Input for the analyses were seven well-known vulnerability and protective factors of healthy aging. By means of community detection, we tested whether we could distinguish subgroups in a sample of 1478 participants (T1-sample, aged 61–101 years). We tested both the external validity (T1) and predictive validity (T2) for wellbeing and subjective cognitive decline. Moreover, replicability and long-term stability were determined in 1186 participants (T2-sample, aged 61–101 years).Results: Three similar subgroups were identified at T1 and T2. Subgroup A was characterized by high levels of education with personal vulnerabilities, subgroup B by being physically active with low support and low levels of education, and subgroup C by high levels of support with low levels of education. Subgroup C showed the lowest wellbeing and memory profile, both at T1 and T2. On most measures of wellbeing and memory, subgroups A and B did not differ from each other. At T2, the same number of subgroups was identified and subgroup profiles at T1 and T2 were practically identical. Per T1 subgroup 47–62% retained their membership at T2.Discussion: We identified valid subgroups that replicate over time and differ on external variables at current and later measurement occasions. Individual change in subgroup membership over time shows that transitions to subgroups with better outcomes are possible.

Highlights

Positive aging trajectories translate to higher wellbeing and better physical functioning, and lower health care costs for society (Bowling and Dieppe, 2005; Kok et al, 2017) but it is difficult to predict who will have such a positive trajectory, and who will require more support
We aim to identify subgroups of aging adults that are either more or less likely to experience subjective cognitive decline and decreased wellbeing; currently, and in the future
Data was requested from the Longitudinal Aging Study Amsterdam (LASA), an ongoing prospective study of older adults living in Netherlands (Hoogendijk et al, 2016)

Summary

Introduction

Positive aging trajectories translate to higher wellbeing and better physical functioning, and lower health care costs for society (Bowling and Dieppe, 2005; Kok et al, 2017) but it is difficult to predict who will have such a positive trajectory, and who will require more support. The aging patterns observed in group studies are diverse. Some groups show strong average decline in functioning as people age, others show less decline or even no decline at all (Grundy and Bowling, 1999; Wilson et al, 2002; Kok et al, 2017). As there are large individual differences it might be more informative to focus on aging patterns of subgroups instead of across the general population. If we overlook these interindividual differences, we may falsely conclude that there is no change due to aging, while different outcomes (e.g., stability, decline, or increase over time) apply to different subgroups. We use easy to measure and modifiable proxies of well-known vulnerability and protective factors for healthy mental aging as input variables

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