Decoding cognitive aging: how white matter tracts and demographics distinguish potential Super-Agers

Abstract

Most adults experience age-related cognitive decline. However, “Positive-Agers” exhibit superior cognition compared to their age-matched peers. Distinguishing between those with superior cognitive performance and those with cognitive decline over time could better inform treatment therapies in older adults. We developed an algorithm called Optimal Cognitive Scoring (OptiCS) that accurately differentiates “Positive-Agers” from “Cognitive Decliners.” The study draws on a cohort of 5797 participants longitudinally enrolled in the UK Biobank. Using a predictive pipeline, OptiCS could strongly differentiate Positive-Agers versus Cognitive Decliners with an area under the curve (AUC) of 83%. The top diffusion MRI attributes highlighted tracts implicated in pathological aging, including the fornix from the hippocampus, the tapetum from the splenium of the corpus callosum, and other key tracts.