Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 6;20(1):203.
doi: 10.1186/s12888-020-02618-9.

Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults

Mu-Cyun Wang  1   2 , Tsai-Chung Li  3 , Chia-Ing Li  2   4 , Chiu-Shong Liu  1   2   4 , Chih-Hsueh Lin  1   2 , Wen-Yuan Lin  1   2 , Chuan-Wei Yang  4 , Shing-Yu Yang  3 , Cheng-Chieh Lin  5   6   7
Affiliations

Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults

Mu-Cyun Wang et al. BMC Psychiatry. .

Abstract

Background: Cognitive impairment is accompanied with high rates of comorbid conditions, leading ultimately to death. Few studies examine the relation between cognitive transition and mortality, especially in Asian population. This study evaluated baseline cognition and cognitive transition in relation to all-cause mortality among community-dwelling older adults.

Methods: We conducted a community-based prospective cohort study among 921 participants of Taichung Community Health Study for Elders in 2009. Cognitive function was evaluated by the Mini-Mental State Examination. Cognitive impairment was considered if the total score is less than 27, 24, and 21 for a participant's educational level of more than 6 years, equal or less than 6 years, and illiteracy, respectively. One-year transition in cognitive function was obtained among 517 individuals who were assessed in both 2009 and 2010. Mortality was followed up until 2016. Cox proportional hazards models were applied to estimate the adjusted hazard ratios of mortality for baseline cognitive impairment and one-year transition in cognitive status.

Results: After a follow-up of 6.62 years, 160 deaths were recorded. The multivariate adjusted hazard ratio (95% confidence interval) for baseline cognitive impairment was 2.08 (1.43, 3.01). Significantly increased mortality risk was observed for cognitively impaired-normal and impaired-impaired subgroups over 1 year as compared with those who remained normal [2.87 (1.25, 6.56) and 3.79 (1.64, 8.73), respectively]. The area under the receiver operating characteristic curves demonstrated that baseline cognition and one-year cognitive transition had no differential predictive ability for mortality. Besides, there was an interaction of cognitive impairment and frailty, with an additive mortality risk [5.41 (3.14, 9.35)] for the elders who presented with both.

Conclusion: Baseline cognitive impairment rather than one-year progression is associated with mortality in a six-year follow-up on older adults.

Keywords: Cognitive function; Cognitive transition; Mini-mental state examination; Mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of recruitment procedures of the current study
Fig. 2
Fig. 2
Survival curves of death for (a) baseline cognitive status and (b) one-year transition in cognitive status
Fig. 3
Fig. 3
The areas under the receiver operating characteristic curves for all-cause mortality: baseline cognitive status versus one-year transition in cognitive status
Fig. 4
Fig. 4
The multivariate adjusted hazard ratios of mortality for baseline cognitive impairment and frailty. Multivariate adjustment for age, sex, education, marital status, BMI, smoking, alcohol drinking, physical activity, exercising program, hypertension, diabetes mellitus, heart disease, hyperlipidemia, gout, hyperuricemia, arthritis, osteoporosis, stroke, cataract, cancer, fall history, and sleep disturbance. *: p < 0.05; **: p < 0.01; ***: p < 0.001
See this image and copyright information in PMC

References

    1. Kinsella K, He W. In: An aging world: 2008. USC B, editor. Washington: U.S. Government Printing Office; 2009.
    1. Murman DL. Seminars in Hearing: 2015: Thieme Medical Publishers. 2015. The impact of age on cognition; pp. 111–121. - PMC - PubMed
    1. Alexander M, Perera G, Ford L, Arrighi HM, Foskett N, Debove C, Novak G, Gordon MF. Age-stratified prevalence of mild cognitive impairment and dementia in European populations: a systematic review. J Alzheimers Dis. 2015;48(2):355–359. - PubMed
    1. Sun Y, Lee HJ, Yang SC, Chen TF, Lin KN, Lin CC, Wang PN, Tang LY, Chiu MJ. A nationwide survey of mild cognitive impairment and dementia, including very mild dementia, in Taiwan. PLoS One. 2014;9(6):e100303. - PMC - PubMed
    1. Millan-Calenti JC, Tubio J, Pita-Fernandez S, Rochette S, Lorenzo T, Maseda A. Cognitive impairment as predictor of functional dependence in an elderly sample. Arch Gerontol Geriatr. 2012;54(1):197–201. - PubMed

Publication types