Longitudinal hippocampal and cognitive trajectories define resilience, stability, vulnerability subgroups in older adults

Longitudinal hippocampal and cognitive trajectories in 415 older adults revealed resilience, stability, vulnerability subgroups. Leading risk indicators: lower plasma Aβ1-42 for resilience, lower education for vulnerability.

• Latent class growth analysis identified three combined trajectory classes: resilience (declining hippocampus/stable cognition), stable (stable/stable), vulnerable (stable/declining).
• Sex-disaggregated machine learning revealed female-specific risk indicators: higher BMI for stability, lower geriatric depression score for stability and vulnerability.
• Risk indicators spanned biological (plasma/CSF Aβ), demographic (education), and genetic (polygenic hazard score) domains.

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