Clustering on longitudinal lifestyle trajectories and their impact on cognitive performance

Alba Roca-Ventura^1,2,3*Javier Solana-Sánchez^1,3,4Gabriele Cattaneo^1,3,4Vanessa Alviarez^1,3,4Goretti España-Irla^1,3,4María Redondo-Camós^1,3,4Selma Delgado-Gallén^1,2,3Ruben Romero^1,3,4Edgar Buloz-Osorio^1,3,4Alvaro Pascual-Leone^5,6David Bartrés-Faz^1,2,7

• ¹Guttmann Brain Health Institute, Barcelona, Spain
• ²Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona,, Barcelona, Spain
• ³Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
• ⁴Autonomous University of Barcelona, Barcelona, Catalonia, Spain
• ⁵Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Roslindale, Massachusetts, United States
• ⁶Department of Neurology, Harvard Medical School, Boston, Massachusetts, United States
• ⁷August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Catalonia, Spain

Lifestyle factors proved its contribution to resilience against cognitive decline and age-related diseases. This study aims to explore the use of longitudinal data clustering to investigate the relationship between self-reported lifestyle trajectories-encompassing modifiable risk factors such as cognitive activity, physical exercise, sleep, socialization, nutrition, alcohol consumption, tobacco use, and BMI-and cognitive performance assessed with in-person neuropsychological testing in healthy middle-aged adults. Data were from the Barcelona Brain Health Initiative (BBHI), an ongoing longitudinal prospective cohort study. Our results reveal the strong impact of adhering to healthy lifestyle patterns on cognitive status. This shows that specific combinations of modifiable factors may be more influential on cognitive maintenance, and that adhering to a higher number of healthy behaviors positively impacts cognitive performance underscoring the significance of education, cognitive activity, psychological health factors and socialization. In the studied period -middle-age to older adults -the cognitive trajectories generally exhibited stability. In conclusion, our findings suggest that k-means clustering successfully identified five unique specific lifestyle profiles with meaningful associations to cognitive status in middle-aged adults, offering promising insights for the development and customization of lifestyle interventions aimed at enhancing brain health and resilience to cognitive decline.