Risk factor profiles and cognitive function in older adults: the Brain Health Support Program Study

Abstract

Background: Dementia risk factors coexist and interact in meaningful ways. Identifying risk profiles can inform prevention strategies.

Methods: This study examined profiles using seven modifiable risk factors and their associations with cognition and sex among older adults at risk of dementia. Risk profiles were identified using principal component analysis, and linear regressions assessed their associations with cognition.

Results: Three profiles emerged: (1) better sleep and social/psychological health; (2) better diet, physical activity, and vascular health; and (3) better cognitive engagement. Similar profiles were observed in women, except that better cognitive engagement grouped with poorer vascular health. In men, better cognitive engagement grouped with better vascular health and vision/hearing, while lower cognitive engagement was grouped with better sleep and social/psychological health. The lower cognitive engagement profile in men was associated with poorer cognition.

Discussion: Prevention strategies should target meaningful combinations of risk factors to improve dementia prevention. Further research is needed to validate and refine these profiles.

Highlights: This study evaluated risk profiles using a broad range of modifiable risk factors.This is the first study to analyze such profiles in a Canadian population, stratified by sex.Risk profiles differed by sex, especially for the cognitive engagement risk factor.In men, lower cognitive engagement profile was associated with poorer cognition.

Plain Language Summary

INTRODUCTION: Risk factors for dementia, such as diet, physical activity, and sleep, often occur together and influence one another. Understanding how these factors cluster, interact, and affect cognition can guide the development of more effective prevention strategies.

METHODS: We studied seven “modifiable” risk factors for dementia—factors that can be changed or managed to reduce risk. Using data from older adults, we identified “profiles” that group these factors together and analyzed their associations with cognition, while also exploring any differences between men and women.

RESULTS: When we analyzed the participants’ risk factors, three main patterns, or « profiles », emerged: 1) better sleep and social/psychological health; 2) healthier diet, more physical activity, and better vascular health; and 3) higher cognitive engagement (how mentally active a person is). Similar profiles were observed in both women and men, but with some differences: In women, higher cognitive engagement was grouped with poorer vascular health. For men, higher cognitive engagement was grouped with better vascular health and vision/hearing, whereas lower cognitive engagement was grouped with better sleep and social/psychological health. In men, lower cognitive engagement was associated with poorer overall cognition (thinking and processing abilities).

DISCUSSION: These findings highlight that dementia risk factors often cluster in meaningful patterns, suggesting that prevention strategies should address these combinations rather than treating those individually. Further research is needed to validate these profiles and refine approaches for more effective dementia prevention.