Mild and moderate cognitive impairment and mortality among Brazilian older adults in long-term follow-up: The Bambui Health Aging Study

Campos, Cecília Godoi; Diniz, Breno S.; Firmo, Josélia Oliveira Araújo; Lima‐Costa, Maria Fernanda; Blay, Sérgio Luís; Castro-Costa, Érico

doi:10.1590/1516-4446-2019-0654

Cited by 12 publications

(8 citation statements)

References 45 publications

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“…Congruently with the above finding, observing the few studies published in the field over the years in Brazil, it is possible to notice a higher prevalence of cognitive impairment for adults over 60 years of age in more recent studies. For instance, the prevalence rate in samples collected until 2000 was between 11.5 and 19.2% [12][13][14][15], while the studies conducted in 2008 [16] and 2011 [17] showed a prevalence of 34.1 and 38.9%, respectively. For this reason, it is critical to identify the trends in cognitive impairment of representative samples across the years to explore the main protective and risk factors to its development, and as a result to provide effective training for health professionals, strategically allocate investments of governments [18], and develop populational health policies [19].…”

Section: Introductionmentioning

confidence: 96%

Changes in prevalence of cognitive impairment and associated risk factors 2000–2015 in São Paulo, Brazil

et al. 2021

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Introduction Decreases in prevalence of cognitive impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. This study aimed to assess the cognitive impairment prevalence and explore associated factors among subjects aged >60 living in São Paulo, Brazil. Method Data came from a population-based Health, Welfare and Aging survey conducted in 2000, 2006, 2010, and 2015. Cognitive impairment was detected using the abbreviated Mini-Mental State Exam corrected by formal education years. In total, there were 5922 respondents in the statistical analyses. Results Logistic regression models adjusted for age group, income, race, cardiovascular risk factors, and depression were used to estimate cognitive impairment prevalence. Between 2015 and 2000, respondents were more likely to report formal education, hypertension, diabetes, and overweight/obesity. Moreover, the weighted analyses showed that cognitive impairment prevalence was higher in 2015, even adjusting for sociodemographic and socioeconomic characteristics, cardiovascular risk factors, and depression. Conclusion In contrast to decreases in cognitive impairment prevalence in other countries and despite increases in educational years, our findings suggest no secular improvements in cognitive health for the 2015 wave of older adults residing in São Paulo.

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Section: Introductionmentioning

confidence: 96%

Changes in prevalence of cognitive impairment and associated risk factors 2000–2015 in São Paulo, Brazil

et al. 2021

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“…To identify cognitive impairment using cut points of 23 or less or 24 or less), the MMSE has a sensitivity of 85 to 92% and a specificity of 85 to 93% [4]. Substantial researches have determined the association between cognitive impairment defined by particular MMSE cutoffs and increased risk of mortality [8][9][10][11][12][13][14][15][16]. To our knowledge, however, the associations between the entire range of MMSE scores, MMSE domains, and all-cause mortality are not well clear.…”

Section: Introductionmentioning

confidence: 99%

Cognitive function assessed by Mini-mental state examination and risk of all-cause mortality: a community-based prospective cohort study

Dong

Sun

et al. 2021

BMC Geriatr

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Background The Mini-Mental State Examination (MMSE) is the most widely used instrument to test cognitive functioning. The present study prospectively investigated the association between MMSE scores, MMSE domains, and all-cause mortality. Methods A total of 2134 participants aged 60 years or over, selected from one urban community-dwelling population in China, were enrolled in the study. The cognitive test was performed by use of the MMSE at baseline, and covariates were recorded simultaneously. Cox regression models were used for examining the cognitive function, expressed by different MMSE transformations, and all-cause mortality. After followed up for a median of 10.8 years (ranging from 1.0 to 11.3 years), loss to follow-up was 13.1% and 1854 individuals were finally included in the analyses. Results The subjects had the mean (SD) age of 71.01 (7.00) years, and 754 (40.67%) of them were women. Per point increase on MMSE scores was associated a 4% decreased risk of all-cause mortality [hazard ratio (HR): 0.96; 95%confidence interval (CI): 0.93–0.98]; compared to MMSE scores of ≥24, MMSE scores of < 24 was associated with a 43% increased risk of all-cause mortality (HR: 1.43; 95% CI: 1.05–1.95); compared to MMSE scores of 30, MMSE scores of 27–29 (HR: 1.27; 95% CI: 0.89–1.82), 24–26 (HR: 1.30; 95% CI: 0.86–1.99), and < 24 (HR: 1.79; 95% CI: 1.15–2.77) had a graded increase in risk of all-cause mortality (p for trend =0.003). Of MMSE domains, orientation to time (HR: 2.00; 95% CI: 1.29–3.11), attention and calculation (HR: 1.49; 95% CI: 1.16–1.92), recall (HR: 2.59; 95% CI: 1.22–5.47), and language (HR: 1.68; 95% CI: 1.25–2.26) were significantly associated with all-cause mortality in the unadjusted model; for one increase in the number of impaired MMSE domains, the unadjusted HR (95% CI) of mortality is 1.51 (1.38, 1.65), and the HR (95% CI) of mortality is 1.12 (1.01, 1.25) with full adjustment; compared to 0 and 1 impaired MMSE domains, the HRs of all-cause mortality associated with 2, 3, 4, and ≥ 5 impaired MMSE domains were 1.14 (95% CI: 0.84–1.54), 1.50 (95% CI: 0.98–2.28), 2.14 (95% CI: 1.12–4.09) and 2.29 (95% CI: 1.24–5.04), respectively, and a dose-dependent relationship was significant (p for trend =0.003). Conclusion Cognitive impairment is associated with the increased risk of all-cause mortality in the Chinese elderly. Similarly, reduced MMSE scores, as well as impaired MMSE domains, are also associated with the increasing risk of all-cause mortality.

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“…The results of Campos et al 6 provide important detail that higher mortality is associated with cognitive impairment in community-dwelling older adults from a middleincome country. In this interesting and relevant study, a branch of the Bambuí Cohort Study of Aging, 7 1,281 older adults from a small rural town in southeastern Brazil were followed for 13.3 years.…”

mentioning

confidence: 98%

Cognitive impairment: an (in)dependent risk factor for mortality in older men?

Loureiro

Pais

Forlenza

2020

Braz. J. Psychiatry

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Mild and moderate cognitive impairment and mortality among Brazilian older adults in long-term follow-up: The Bambui Health Aging Study

Cited by 12 publications

References 45 publications

Changes in prevalence of cognitive impairment and associated risk factors 2000–2015 in São Paulo, Brazil

Changes in prevalence of cognitive impairment and associated risk factors 2000–2015 in São Paulo, Brazil

Cognitive function assessed by Mini-mental state examination and risk of all-cause mortality: a community-based prospective cohort study

Cognitive impairment: an (in)dependent risk factor for mortality in older men?

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