Longitudinal Lifestyle Profiles Influence Health Trajectories in Aging: Evidence from a Population-Based Sample

INTRODUCTION: As the global population is aging at an accelerated pace, understanding how changes in modifiable lifestyles are related to positive health outcomes is crucial. This study aimed to discover the distinct profile of changes in lifestyle habits during aging, and their impact on cognitive, mental, and physical health. Next, we rated the unique contribution of each lifestyle on health outcomes. METHODS: The study was conducted on 966 older adults from the InveCe.Ab population-based cohort, all dementia-free at baseline (70-75 years), with at least three multidimensional assessments performed over 12 years. A multivariate longitudinal K-means clustering approach grouped participants based on the longitudinal patterns of six lifestyle habits (physical activity, healthy diet, smoking, alcohol use, cognitive activity, and social engagement). Then, we explored the longitudinal association of lifestyle patterns on cognitive (Mini-Mental State Examination), mental (Geriatric Depression Scale), and physical (Cumulative Illness Rating Scale, single- and dual-task walking speed test) health. RESULTS: Longitudinal clustering identified three different profiles: cluster B (n = 390, 40%) exhibited the healthiest lifestyle pattern and showed better cognitive, mental, and physical trajectories compared to clusters A (n = 531, 55%) and C (n = 45, 5%). Among the health behaviors considered, physical activity, social engagement, and cognitive activity were independently associated with better health outcomes. CONCLUSION: Consistent engagement in health-promoting behaviors during aging led to measurable benefit across the main health domains (cognitive, mental, physical). These findings highlight the need for multifaceted community-level lifestyle interventions to promote health aging.