TY - JOUR
T1 - Degree of cognitive impairment and mortality
T2 - A 17-year follow-up in a community study
AU - Santabárbara, J.
AU - Lopez-Anton, R.
AU - Marcos, G.
AU - De-La-Cámara, C.
AU - Lobo, E.
AU - Saz, P.
AU - Gracia-Garciá, P.
AU - Ventura, T.
AU - Campayo, A.
AU - Rodríguez-Manãs, L.
AU - Olaya, B.
AU - Haro, J. M.
AU - Salvador-Carulla, L.
AU - Sartorius, N.
AU - Lobo, A.
N1 - Publisher Copyright:
© 2014 Cambridge University Press.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background. To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments; and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment. Method. A representative random community sample of individuals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages. Results. Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the 'mild' degree of impairment; HR: 1.29 in the 'moderate' degree; and HR: 2.08 in the 'severe' degree). The PAF of mortality due to severe cognitive impairment was 3.49%. Conclusions. A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.
AB - Background. To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments; and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment. Method. A representative random community sample of individuals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages. Results. Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the 'mild' degree of impairment; HR: 1.29 in the 'moderate' degree; and HR: 2.08 in the 'severe' degree). The PAF of mortality due to severe cognitive impairment was 3.49%. Conclusions. A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.
KW - Cognitive impairment
KW - Mini Mental Status Examination
KW - mortality
KW - population-attributable fraction
UR - http://www.scopus.com/inward/record.url?scp=84949321082&partnerID=8YFLogxK
U2 - 10.1017/S2045796014000390
DO - 10.1017/S2045796014000390
M3 - Article
SN - 2045-7960
VL - 24
SP - 503
EP - 511
JO - Epidemiology and Psychiatric Sciences
JF - Epidemiology and Psychiatric Sciences
IS - 6
ER -