ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025
Compression of cognitive decline and cognitive resilience in extreme longevity.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Menopausal insomnia as a modifiable node of dementia risk: Mechanistic insights and intervention strategies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- Cerebral amyloid associated with global cognition is differentially moderated by pulse pressure across education levels in The 90+ Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Divergent trends in Alzheimer's disease burden: a comparative analysis of the US and G20 nations.International journal of public health · 2026Article
- Compression of cognitive decline and cognitive resilience in extreme longevity.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundCompressing the duration of cognitive impairment is critical to preserve quality of life until the end. To what extent cognitive decline is compressed and cognitive resilience increases with extreme longevity is not well understood.
methodsWe used data from 13,999 deceased participants from the National Alzheimer's Coordinating Center cohort, including 8,146 with neuropathological data. Cognitive function was assessed annually (median follow-up: 4.9 years). We evaluated cognitive trajectories before death and cognitive resilience (defined as high neuropathological burden without dementia) across lifespan groups (ages 50-100+ years).
resultsParticipants with longer lifespans, particularly centenarians, exhibited slower cognitive decline and shorter periods of cognitive impairment before death, although distinct cognitive trajectories existed among centenarians. Cognitive resilience also increased with longer lifespans, but associated factors varied. Apolipoprotein E ε2 was associated with higher cognitive resilience only in centenarians.
conclusionOur findings support a general compression of cognitive decline and increased cognitive resilience in extreme longevity. HIGHLIGHTS: Individuals with longer lifespans, especially centenarians, generally exhibited better cognitive function and slower cognitive decline toward the end of life, suggesting a compression of cognitive decline in extreme longevity. Although there was a compression of cognitive decline at the group level among centenarians, heterogeneous cognitive trajectories before death were observed across individuals. The relationship between neuropathological burden and dementia risk attenuated with longer lifespans, indicating greater cognitive resilience in individuals with extreme longevity. The associations of both genetic and modifiable factors with cognitive resilience varied by lifespan.
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