Trajectories of Multiple Behavioral Risk Factors and Their Associations With Cognitive Function Trajectories Among Older African Americans and White Americans

Objectives: This study examined the joint trajectories of behavioral risk factors (smoking, alcohol drinking, and body mass index) and their associations with cognitive function trajectories among older African Americans and white Americans. Methods: Data from the Health and Retirement Study (1998-2014) were used. Group-based mixture modeling and multinomial logistic regression analysis were performed. Results: Three joint trajectories of behavioral risk factors (overweight, smoking and drinking, and drinking and overweight) and three cognitive function trajectories (low, moderate, and high) were identified. A significantly higher percentage of African Americans were in the overweight, smoking and drinking, and low cognitive functioning groups as measured by the total cognition composite score compared to white Americans. After accounting for covariates, the drinking and overweight group was associated with the moderate or high cognitive functioning group. Discussion: Future interventions targeting the combinations of behavioral risk factors are needed to promote healthy aging among high-risk populations.

Automated summary

This study identified three joint trajectories of behavioral risk factors and cognitive function among older African Americans and white Americans. African Americans were found to have higher rates of overweight, smoking and drinking, and low cognitive functioning compared to white Americans. Future interventions targeting combinations of behavioral risk factors are needed to promote healthy aging among high-risk populations.