Preserved cognitive–functional phenotype in centenarians and its association with modifiable risk factors for dementia: Results from the Colombian centenarians project

INTRODUCTION: Research on dementia in centenarians is scarce. This study assesses the 2024 Lancet Commission risk factors for dementia in Colombian centenarians. METHODS: The Clinical Dementia Rating—Sum of Boxes (CDR-SB), Mini-Mental State Examination, and Barthel Index were evaluated in Colombian centenarians. A preserved cognitive–functional phenotype (PCFP), defined by a CDR-SB <2 and a Barthel index ≥60, was utilized to signify the absence of dementia based on cognitive screening instruments. Associations with age-related clinical variables were assessed through multivariate analyses. RESULTS: Among 160 centenarians, 63.7% did not meet the PCFP criteria and were classified as having dementia. Frailty, alcohol intake, and depression were linked to dementia, while physical performance, nutritional status, and quality of life were associated with PCFP. Physical activity, education, obesity, hypertension, diabetes, and smoking showed no significant associations. DISCUSSION: Traditional dementia risk factors were not universally confirmed in centenarians, underscoring the need for prevention strategies tailored to specific settings. Highlights: Dementia risk factors act differently in Colombian centenarians. Frailty and malnutrition strongly linked to dementia in centenarians. Preserved cognitive-functional phenotype identified in 36% of centenarians. Quality of life and physical performance protect against cognitive decline. Classical risk factors (education, hypertension, diabetes) showed no effect.