Body Mass Index, Cognition, Disability, APOE Genotype, and Mortality: The “Treviso Longeva” Study

Gustafson, Deborah; Mazzuco, Stefano; Ongaro, Fausta; Antuono, Piero; Forloni, Gianluigi; Albani, Diego; Gajo, Giovanni Battista; Durante, Elisabetta; Caberlotto, Livio; Zanardo, Andrea; Siculi, Marinella; Gallucci, Maurizio

doi:10.1097/jgp.0b013e31823031a4

Cited by 25 publications

(24 citation statements)

References 43 publications

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“…Other predictors that have been consistently shown to be risk factors for mortality include older age, male gender, history of diabetes and cardiovascular diseases [27]. Interestingly, in our cohort education was not associated with mortality after adjusting for cognitive function, although the majority of our cohort has little or no education (62%).…”

Section: Discussionmentioning

confidence: 58%

Cognitive function, body mass index and mortality in a rural elderly Chinese cohort

et al. 2014

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BackgroundPrevious studies have shown that poor cognition and low body mass index were associated with increased mortality. But few studies have investigated the association between cognition and mortality across the entire cognitive spectrum while adjusting for BMI. The objective of this study is to examine the associations between cognitive function, BMI and 7-year mortality in a rural elderly Chinese cohort.MethodsA prospective cohort of 2,000 Chinese age 65 and over from four rural counties in China were followed for 7-years. Cognitive function, BMI and other covariate information were obtained at baseline. Cox’s proportional hazard models were used to determine the effects of cognitive function and BMI on mortality risk.ResultsOf participants enrolled, 473 (23.7%) died during follow-up. Both lower cognitive function (HR = 1.48, p = 0.0049) and lower BMI (HR = 1.6, p < 0.0001) were independently associated with increased mortality risk compared to individuals with average cognitive function and normal weight. Higher cognitive function was associated with lower mortality risk (HR = 0.69, p = 0.0312). We found no significant difference in mortality risk between overweight/obese participants and those with normal weight.ConclusionsCognitive function and BMI were independent predictors of mortality risk. Intervention strategies for increasing cognitive function and maintaining adequate BMI may be important in reducing morality risk in the elderly population.

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Section: Discussionmentioning

confidence: 58%

Cognitive function, body mass index and mortality in a rural elderly Chinese cohort

et al. 2014

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“…Other studies on older populations found significant associations between functional disability and cognitive impairment and an increased risk of mortality, independent of several confounding variables [12, 25, 26, 31, 32, 37]. The relationship between cognitive impairment and disability is multifaceted.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated that cognitive impairment is an independent predictor of mortality for adults aged 80 years and older after adjusting for many diverse covariates [12, 25, 26, 31, 32, 36, 37]. A 2-year longitudinal household follow-up study by Ramos et al [25] enrolled 1667 urban community residents aged 65 years and older (including around 370 subjects aged 80 and older); after controlling for age, gender, geriatric syndrome (incontinence, falls, dysthymia), ADL, and other factors, but not chronic disease, mortality risk increased significantly for very old subjects (80 years vs. 65 years), extremely dependent subjects (7 vs. 0 ADLs), and those with severe cognitive impairment (<18 vs. 30 MMSE).…”

Section: Discussionmentioning

confidence: 99%

“…A 2-year longitudinal household follow-up study by Ramos et al [25] enrolled 1667 urban community residents aged 65 years and older (including around 370 subjects aged 80 and older); after controlling for age, gender, geriatric syndrome (incontinence, falls, dysthymia), ADL, and other factors, but not chronic disease, mortality risk increased significantly for very old subjects (80 years vs. 65 years), extremely dependent subjects (7 vs. 0 ADLs), and those with severe cognitive impairment (<18 vs. 30 MMSE). Gustafson et al [26] reported that global cognition (< = 24 on the MMSE) and physical disability were significant predictors for 7-year mortality in 668 long-lived Italian subjects aged 70 years or older (mean age 84±8 years) after adjusting for age, gender, BMI, APOEe4, ADL, and chronic diseases. In Sweden, an 8-year population-based prospective cohort study focused on non-dementia among people aged 75–95 years, concluding that cognitive impairment was a major risk factor for mortality, and its effect was not mediated by physical disability or other factors [12].…”

Section: Discussionmentioning

confidence: 99%

“…Both physical disability and cognitive impairment were common conditions with adverse outcomes in later life. Although several previous studies demonstrated that both cognitive impairment and disability were independent of adverse impact on mortality [22–26], the attributable mortality risk of cognitive impairment may be explained by functional disability [27]. Most previous studies focused on independent associations between cognitive impairment or disability and mortality, however, effects of the interrelationship between physical disability and cognitive impairment on mortality remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study

Chou²,

Peng

et al. 2017

PLoS ONE

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ObjectiveWe evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan.MethodsThis prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson’s Comorbidity Index (CCI), geriatric syndromes, activities of daily living (ADL) using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE). Subjects were categorized into normal cognitive function, mild cognitive deterioration, and moderate-to-severe cognitive impairment and were further stratified by physical disability status. Kaplan-Meier log-rank test was used for survival analysis. After adjusting for sociodemographic characteristics and geriatric syndromes, Cox proportional hazards model was constructed to examine associations between cognitive function, disability and increased mortality risk.ResultsAmong 305 male subjects aged 85.1 ± 4.1 years, 89 subjects died during follow-up (mean follow-up: 1.87 ± 0.90 years). Kaplan-Meier unadjusted analysis showed reduced survival probability associated with moderate-to-severe cognitive status and physical disability. Mortality risk increased significantly only for physically disabled subjects with simultaneous mild cognitive deterioration (adjusted HR 1.951, 95% CI 1.036–3.673, p = 0.038) or moderate-to-severe cognitive impairment (aHR 2.722, 95% CI 1.430–5.181, p = 0.002) after adjusting for age, BMI, education levels, smoking status, polypharmacy, visual and hearing impairment, urinary incontinence, fall history, depressive symptoms and CCI. Mortality risk was not increased among physically independent subjects with or without cognitive impairment, and physically disabled subjects with intact cognition.ConclusionsPhysical disability is a major risk factor for all-cause mortality among men aged 80 years and older, and risk increased synergistically when cognitive impairment was present. Cognitive impairment alone without physical disability did not increase mortality risk in this population.

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Disparities in mortality by disability: an 11-year follow-up study of 1 million individuals

Park

Roh

et al. 2017

Int J Public Health

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Body Mass Index, Cognition, Disability, APOE Genotype, and Mortality: The “Treviso Longeva” Study

Cited by 25 publications

References 43 publications

Cognitive function, body mass index and mortality in a rural elderly Chinese cohort

Cognitive function, body mass index and mortality in a rural elderly Chinese cohort

Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study

Disparities in mortality by disability: an 11-year follow-up study of 1 million individuals

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