Midlife sensory and motor measures among best predictors in parsimonious models of long-term cognitive decline and incidence of cognitive impairment in aging adults

INTRODUCTION: We aimed to construct a parsimonious risk prediction model of 10-year cognitive decline and impairment using factors measured in midlife. METHODS: Longitudinal data of N = 1,529 (mean age 49 years; 54% women) Beaver Dam Offspring Study participants were included. We assessed several health measures at baseline and 10-year cognitive decline and cognitive impairment. We constructed Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression models. RESULTS: The top cognitive decline predictors (age, income, fine-motor skills, olfaction, peripheral artery disease, and serum neurofilament light chain protein [NfL]) and cognitive impairment predictors (sex, fine-motor skills, olfaction, self-rated vision, alcohol consumption, and NfL) yielded areas under the receiver operating characteristic curves (AUCs) of 0.80 (95% confidence interval [0.76-0.83]) and 0.73[0.69-0.77], respectively. DISCUSSION: In middle-aged adults, sensory and motor function and NfL were among the best predictors of 10-year onset of cognitive decline and impairment. After external validation in other studies, these results could help identify those at risk for neurodegeneration and cognitive decline who could benefit from early interventions.