An examination of the heterogeneity in the pattern and association between rates of change in grip strength and global cognition in late life. A multivariate growth mixture modelling approach.

ABSTRACT

Background: previous research has demonstrated how older adults exhibit different patterns of change in cognitive and physical functioning, suggesting differences in the underlying causal processes. Objective: to (i) identify subgroups of older adults that best account for different patterns of longitudinal change in performance on global cognition and grip strength, (ii) examine the interrelationship between global cognition and grip strength trajectories within these subgroups and (iii) identify demographic and health-related markers of class membership. Methods: multivariate growth mixture models (GMM) were used to identify groups of individuals with similar developmental trajectories of muscle strength measured by grip strength, and global cognition measured by Mini Mental State Examination (MMSE). Results: GMM analyses indicated high, moderate and low functioning groups. Individuals in the high and moderate classes demonstrated better cognitive and physical functioning at the start of the study and less decline than those in the low functioning group. Notably, cognitive performance was related to physical functioning at study entry only among individuals in the low functioning group. Conclusion: the study demonstrates the applicability of the multivariate GMM to achieve a better understanding of the heterogeneity of various aging related processes.