J Santabárbara1, R Lopez-Anton2, G Marcos1, C De-la-Cámara2, E Lobo1, P Saz2, P Gracia-García2, T Ventura2, A Campayo2, L Rodríguez-Mañas3, B Olaya2, J M Haro2, L Salvador-Carulla4, N Sartorius5, A Lobo2. 1. Department of Preventive Medicine and Public Health,Universidad de Zaragoza,Zaragoza,Spain. 2. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Ministry of Science and Innovation,Madrid,Spain. 3. Hospital Universitario de Getafe and Red Tematica de Investigacion Cooperativa en Envejecimiento y Fragilidad (RETICEF),Madrid,Spain. 4. Centre for Disability Research and Policy,Faculty of Health Sciences,University of Sydney,Sydney,Australia. 5. Association for the Improvement of Mental Health Programmes (AMH),Geneva,Switzerland.
Abstract
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.
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.
Entities:
Keywords:
Cognitive impairment; Mini Mental Status Examination; mortality; population-attributable fraction
Authors: J Santabárbara; R Lopez-Anton; P Gracia-García; C De-la-Cámara; D Vaquero-Puyuelo; E Lobo; G Marcos; L Salvador-Carulla; T Palomo; N Sartorius; A Lobo Journal: Epidemiol Psychiatr Sci Date: 2015-10-15 Impact factor: 6.892
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