Aging has often been characterized by progressive cognitive decline in memory and especially executive function. Yet some adults, aged 80 years or older, are “super-agers” that exhibit cognitive performance like younger adults. It is unknown if there are adults in mid-life with similar superior cognitive performance (“positive-aging”) versus cognitive decline over time and if there are blood biomarkers that can distinguish between these groups. Among 1303 participants in UK Biobank, latent growth curve models classified participants into different cognitive groups based on longitudinal fluid intelligence (FI) scores over 7–9 years. Random Forest (RF) classification was then used to predict cognitive trajectory types using longitudinal predictors including demographic, vascular, bioenergetic, and immune factors. Feature ranking importance and performance metrics of the model were reported. Despite model complexity, we achieved a precision of 77% when determining who would be in the “positive-aging” group (n = 563) vs. cognitive decline group (n = 380). Among the top fifteen features, an equal number were related to either vascular health or cellular bioenergetics but not demographics like age, sex, or socioeconomic status. Sensitivity analyses showed worse model results when combining a cognitive maintainer group (n = 360) with the positive-aging or cognitive decline group. Our results suggest that optimal cognitive aging may not be related to age per se but biological factors that may be amenable to lifestyle or pharmacological changes.

衰老的特点通常是记忆力、特别是执行功能的逐渐认知衰退。然而，一些 80 岁或以上的成年人是“超级老年人”，表现出像年轻人一样的认知能力。目前尚不清楚是否有中年成年人具有类似的卓越认知表现（“积极衰老”）与随着时间的推移认知能力下降，以及是否有血液生物标志物可以区分这些群体。在英国生物银行的 1303 名参与者中，潜在生长曲线模型根据 7-9 年的纵向流体智力 (FI) 分数将参与者分为不同的认知组。然后使用随机森林 (RF) 分类来使用包括人口统计、血管、生物能量和免疫因素在内的纵向预测因子来预测认知轨迹类型。报告了模型的特征排名重要性和性能指标。尽管模型很复杂，但在确定谁属于“积极衰老”组 ( n  = 563) 与认知衰退组 ( n  = 380) 时，我们的精度达到了 77%。在前十五个特征中，同等数量的特征与血管健康或细胞生物能量相关，但与年龄、性别或社会经济地位等人口统计特征无关。敏感性分析显示，将认知维持组 ( n  = 360) 与积极衰老组或认知衰退组相结合时，模型结果更差。我们的研究结果表明，最佳认知衰老可能与年龄本身无关，而与可能受生活方式或药理变化影响的生物因素有关。