TY - JOUR
T1 - Long-term Cognitive Trajectories and Mortality in Older Women
AU - Yaffe, Kristine
AU - Peltz, Carrie B.
AU - Ewing, Susan K.
AU - McCulloch, Charles E.
AU - Cummings, Steve R.
AU - Cauley, Jane A.
AU - Hillier, Teresa A.
AU - Ensrud, Kristine E.
N1 - Publisher Copyright:
© 2016 The Author. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - 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.
AB - 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.
KW - All-cause mortality
KW - Cardiovascular mortality
KW - Cognitive trajectories
KW - Executive function
KW - Global cognition
KW - Oldest old
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U2 - 10.1093/gerona/glw003
DO - 10.1093/gerona/glw003
M3 - Article
C2 - 26843186
AN - SCOPUS:84981276055
SN - 1079-5006
VL - 71
SP - 1074
EP - 1080
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 8
ER -