Vital status after five-year follow-up of nonagenarians with functional and/or cognitive impairment at baseline: the NonaSantfeliu study

Abstract

Objectives: To evaluate vital status after five years of follow-up in a cohort of nonagenarians with functional and/or cognitive impairment at baseline.

Design: Prospective cohort study.

Setting: A community-based study.

Participants: Nonagenarians enrolled in the NonaSantfeliu study.

Measurements: Functional status was determined by the Lawton-Brody and Barthel indexes (BI), while cognition was assessed using the Spanish version of the Mini-Mental State Examination (MEC). Nonagenarians scoring up to 59 points on the BI were defined as individuals with significant functional impairment. Nonagenarians with cognitive decline were defined as those individuals with a score of 23 or less on the MEC. Subjects scoring < 60 on the BI and < 24 on the MEC were considered to show combined impairment (both functional and cognitive).

Results: Sixty-three of 71 (88.8%) subjects with a BI < 60 and 73 of 84 (86.9%) with a MEC score < 24 had died after five years. Forty-eight of 53 nonagenarians (90%) with combined impairment died during the same follow-up period. A prior diagnosis of heart failure was the only variable associated with higher mortality in the three groups of subjects.

Conclusion: Most of the nonagenarian subjects with functional and/or cognitive impairment at baseline had died at five-year follow-up.