Trajectories of combined laboratory- and real world-based speed of processing in community-dwelling older adults.

OBJECTIVES To characterize the trajectories of laboratory- and real world-based speed of processing (SOP) over 5 years using finite latent growth mixture modeling, and to explore associated baseline individual-level predictors and functional outcomes in 2,802 community-dwelling older adults from the Advanced Cognitive Training for Independent and Vital Elderly cohort. METHOD Laboratory- and real world-based SOP and functional outcomes were assessed over 5 years, and candidate individual-level predictors were collected at baseline. RESULTS After controlling for intervention assignment and demographic information, 4 distinct trajectories were identified: 4.6% of older adults had poor laboratory-based SOP and very poor real world-based SOP that both declined substantially over time; 17.9% had poor laboratory- and real world-based SOP that declined moderately; 38.7% had neutral laboratory- and real world-based SOP that maintained stable; and 37.9% had good laboratory- and real world-based SOP that declined slightly. Non-White, depression, subjective memory complaints, and vascular factors predicted the trajectories. The trajectories significantly differed in the rate of decline in basic activities of daily living, instrumental activities of daily living, and grip strength over time. DISCUSSION Heterogeneous trajectories of SOP exist in old age. Future interventions addressing SOP should target the vulnerable group with poor SOP over time.