Introduction
Some individuals reach ages beyond 100 years and become centenarians with intact cognitive functions,1-5 which indicates that cognitive impairment is not inevitable at extreme ages. Cross-sectional and longitudinal studies in younger age groups (20-90 years) have shown that aging is accompanied by a maintenance in language, semantic knowledge, abstract reasoning, and visuospatial functions, whereas a vulnerability is observed in domains such as processing speed, executive functions, and episodic and working memory.6-11 It is still unclear to what extent individuals who maintain cognitive health until age 100 years escape or delay decline across different cognitive domains. Based on the 40% incidence of dementia at age 100 years, and assuming a continued increase beyond 100, it is to be expected that a decline in cognitive functions will be observable in this age group.12,13

In this study, we aim to identify trajectories of cognitive performance in different domains for cognitively healthy centenarians, and to explore associations with risk factors of cognitive decline, including neuropathology associated with Alzheimer disease (AD) and factors of cognitive reserve.14,15
Beker N, Ganz A, Hulsman M, et al. Association of Cognitive Function Trajectories in Centenarians With Postmortem Neuropathology, Physical Health, and Other Risk Factors for Cognitive Decline. JAMA Netw Open. 2021;4(1):e2031654. doi:10.1001/jamanetworkopen.2020.31654