Most older adults maintain stable cognitive functioning, independence and healthy social lives as they age, according to a new longitudinal study from Karolinska Institutet. The findings also show that stronger social support may help some people cope with declining cognition without losing everyday independence.
In a collaborative study between Karolinska Institutet and Radboud University Medical Center in the Netherlands, published in Innovation in Aging, researchers followed nearly 3,000 older adults living in Kungsholmen in central Stockholm for 15 years. They examined how cognitive ability, daily functioning and different aspects of social health changed over time.
The results show that most participants followed stable trajectories across cognitive, daily functioning and social health. However, smaller groups experienced faster or uneven declines. Some people showed worsening cognitive functioning, while others had more difficulties managing everyday tasks, and these changes did not always happen at the same pace.
"We wanted to understand whether changes in cognition, daily functioning and social health evolve together over time, or if they sometimes diverge," say Anna Marseglia and Amaia Calderón Larrañaga , researchers at the Department of Neurobiology, Care Sciences and Society , Karolinska Institutet.
Social health
The researchers also looked more closely at social health, which includes social activities, social connections and social support. Older adults who participated in fewer leisure activities or had weaker social connections were more likely to experience declines in cognition or daily functioning.
One group stood out. Despite declining cognitive abilities, these individuals managed to remain independent in their daily lives. Over time, they reported increasing social support from people around them. "This suggests that support from family, friends or the community may help compensate when cognitive abilities start to decline," says Anna Marseglia. "It is a hypothesis that needs further testing, but it highlights social support as a key factor to promote functional independence when cognition deteriorates."
Differences between women and men
The study also found differences between women and men, with women more likely to maintain stable social connections over time. By identifying subgroups that decline faster and in different ways, and by observing how support from the surrounding environment influences cognitive and functional trajectories, the researchers hope the findings can help identify who may need earlier or more tailored support.
"Our findings strengthen the idea that social health is more than participation alone. It consists of several dimensions that can change at different rates over time and are likely to respond to adjustments in a person's environment. We still do not know exactly what drives these complex dynamics, but we believe that stress, the onset of chronic conditions affecting multiple organ systems as people age, and overall lifestyle play an important role" says Anna Marseglia.
"Aging does not follow a single path," say the authors. "Understanding these differences may help families, healthcare services and policymakers support healthy aging in the community."
The study is part of the JPND-funded SHARED consortium and supported by several Swedish researcher funders such as FORTE, and conducted within the TraCeDem center at Karolinska Institutet.
Publication
" Trajectories of social health, cognitive, and daily functioning in community-dwelling older adults ", Anna Marseglia, Eline Verspoor, Marieke Perry, Myrra Vernooij-Dassen, Jeannie-Marie S Leoutsakos, Henry Brodaty, Jean Stafford, Mohammad Arfan Ikram, Joanna Rymaszewska, Anna-Karin Welmer, Karin Wolf-Ostermann, Frank J Wolters, Amaia Calderón-Larrañaga, René J F Melis, SHARED Consortium, Innovation in Aging, online 3 February 2026, doi: 10.1093/geroni/igag010.
