Kristine Yaffe1, Carrie B Peltz2, Susan K Ewing3, Charles E McCulloch3, Steve R Cummings3, Jane A Cauley4, Teresa A Hillier5, Kristine E Ensrud6. 1. Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco. Department of Mental Health, San Francisco VA Medical Center, California. 2. Department of Mental Health, San Francisco VA Medical Center, California. NCIRE-The Veterans Health Research Institute, San Francisco, California. carrie.peltz2@va.gov. 3. Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco. 4. Department of Epidemiology, University of Pittsburgh, Pennsylvania. 5. Kaiser Permanente Center for Health Research Northwest/Hawaii, Portland, Oregon. 6. School of Public Health, University of Minnesota, Minneapolis. Department of Medicine, Minneapolis VA Health Care System, Minnesota.
Abstract
BACKGROUND: Few studies have examined whether change in cognition is linked to mortality. This study examined the relationship between cognitive trajectories in older age and risk of death. METHODS: We studied community-dwelling, nondemented women aged 65+ (mean age = 71) enrolled in a prospective study of aging and followed up to 25 years. A modified Mini-Mental State Examination (mMMSE) and Trail Making Task Part B (TMTB) were administered at multiple visits during follow-up. We examined the association between cognitive trajectories (analyzed by quintiles) from baseline to age 80 (n = 7,477 for mMMSE and n = 6,503 for TMTB) and all-cause mortality after age 80 using Cox regression models, both unadjusted and adjusted for education, physical activity, alcohol, depression score, current smoking and history of hypertension and diabetes. Cause of death was determined from death certificates, classified as cardiovascular, cancer and other. RESULTS: Women with greater rate of decline were older, less educated, less physically active, had higher depression score and were more likely to have a history of hypertension and diabetes (all p < .01). Participants with the greatest decline (quintile 1) had an increased risk of death (mMMSE hazard ratio [HR] = 1.28; TMTB HR = 1.43] and those with the least decline (quintile 5) had a decreased risk of death (mMMSE HR = 0.73; TMTB HR = 0.61) compared with intermediate decliners (quintiles 2-4). Cognitive trajectories were associated with cardiovascular mortality and other causes of death, but not cancer deaths. CONCLUSIONS: Our study suggests that greater decline in general cognition or executive function is associated with higher rates of mortality in oldest-old women.
BACKGROUND: Few studies have examined whether change in cognition is linked to mortality. This study examined the relationship between cognitive trajectories in older age and risk of death. METHODS: We studied community-dwelling, nondemented women aged 65+ (mean age = 71) enrolled in a prospective study of aging and followed up to 25 years. A modified Mini-Mental State Examination (mMMSE) and Trail Making Task Part B (TMTB) were administered at multiple visits during follow-up. We examined the association between cognitive trajectories (analyzed by quintiles) from baseline to age 80 (n = 7,477 for mMMSE and n = 6,503 for TMTB) and all-cause mortality after age 80 using Cox regression models, both unadjusted and adjusted for education, physical activity, alcohol, depression score, current smoking and history of hypertension and diabetes. Cause of death was determined from death certificates, classified as cardiovascular, cancer and other. RESULTS:Women with greater rate of decline were older, less educated, less physically active, had higher depression score and were more likely to have a history of hypertension and diabetes (all p < .01). Participants with the greatest decline (quintile 1) had an increased risk of death (mMMSE hazard ratio [HR] = 1.28; TMTB HR = 1.43] and those with the least decline (quintile 5) had a decreased risk of death (mMMSE HR = 0.73; TMTB HR = 0.61) compared with intermediate decliners (quintiles 2-4). Cognitive trajectories were associated with cardiovascular mortality and other causes of death, but not cancer deaths. CONCLUSIONS: Our study suggests that greater decline in general cognition or executive function is associated with higher rates of mortality in oldest-old women.
Authors: A E Korten; A F Jorm; Z Jiao; L Letenneur; P A Jacomb; A S Henderson; H Christensen; B Rodgers Journal: J Epidemiol Community Health Date: 1999-02 Impact factor: 3.710
Authors: Kristine Yaffe; Karla Lindquist; Eric Vittinghoff; Deborah Barnes; Eleanor M Simonsick; Anne Newman; Suzanne Satterfield; Caterina Rosano; Susan M Rubin; Hilsa N Ayonayon; Tamara Harris Journal: J Am Geriatr Soc Date: 2010-04-06 Impact factor: 5.562
Authors: Robert S Wilson; Laurel A Beckett; Lisa L Barnes; Julie A Schneider; Julie Bach; Denis A Evans; David A Bennett Journal: Psychol Aging Date: 2002-06
Authors: Brenna Cholerton; Adam Omidpanah; Steven P Verney; Lonnie A Nelson; Laura D Baker; Astrid Suchy-Dicey; William T Longstreth; Barbara V Howard; Jeffrey A Henderson; Thomas J Montine; Dedra Buchwald Journal: Int J Geriatr Psychiatry Date: 2019-04-15 Impact factor: 3.485
Authors: Zimu Wu; Robyn L Woods; Trevor T J Chong; Suzanne G Orchard; Raj C Shah; Rory Wolfe; Elsdon Storey; Kerry M Sheets; Anne M Murray; John J McNeil; Joanne Ryan Journal: Front Med (Lausanne) Date: 2022-06-27
Authors: Andrea L Roberts; Jiaxuan Liu; Rebecca B Lawn; Shaili C Jha; Jennifer A Sumner; Jae H Kang; Eric B Rimm; Francine Grodstein; Laura D Kubzansky; Lori B Chibnik; Karestan C Koenen Journal: JAMA Netw Open Date: 2022-06-01
Authors: Elena Lobo; Patricia Gracia-García; Antonio Lobo; Pedro Saz; Concepción De-la-Cámara Journal: Int J Environ Res Public Health Date: 2021-07-02 Impact factor: 3.390
Authors: Nadia M Chu; Xiaomeng Chen; Alden L Gross; Michelle C Carlson; Jacqueline M Garonzik-Wang; Silas P Norman; Aarti Mathur; Maheen Z Abidi; Daniel C Brennan; Dorry L Segev; Mara A McAdams-DeMarco Journal: Clin Transplant Date: 2021-08-03 Impact factor: 3.456