Level of Cognitive Impairment Predicts Mortality in High-Risk Community Samples: The Memory and Medical Care Study

Lee, Ho-Chang; Kasper, Judy; Shore, Andrew D.; Yokley, B.A. Jessica L.; Black, Betty S.; Rabins, M.H.S. Peter V.

doi:10.1176/jnp.2006.18.4.543

Cited by 18 publications

(12 citation statements)

References 13 publications

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“…Within 3 years, 500 to 600 older persons with malnutrition, 351 with cognitive impairment, and 534 with severe dementia died per 1,000 older persons . Within 5 years, 490 elderly persons with malnutrition, 513 with frailty, 530 with high CRP, and 827 to 941 with vascular dementia died per 1,000 older persons .…”

Section: Discussionmentioning

confidence: 99%

The Association Between Geriatric Syndromes and Survival

Kane

Shamliyan

Talley

et al. 2012

J American Geriatrics Society

174

126

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Section: Discussionmentioning

confidence: 99%

The Association Between Geriatric Syndromes and Survival

Kane

Shamliyan

Talley

et al. 2012

J American Geriatrics Society

174

126

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“…The survival of patients with neurodegenerative disease has been investigated in multiple studies of Alzheimer's disease (AD) [1][2][3][4][5][6][7][8][9][10] , possible AD [1,2,[10][11][12][13] , amyotrophic lateral sclerosis (ALS) [14][15][16][17] , and Parkinson's disease (PD) [18][19][20][21][22][23][24][25][26] . There are 8 studies (5 in a review article) of survival of patients diagnosed with mild cognitive impairment (MCI) [27][28][29][30] . There are also several studies with data on survival of frontotemporal dementia (FTD) patients [31][32][33][34] , and 1 with data on survival of Lewy body disease (LBD) patients [35] .…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Survival of Patients with Neurodegenerative Disease

Steenland¹,

MacNeil²,

Seals³

et al. 2010

Neuroepidemiology

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Background: Survival varies widely among different neurodegenerative diseases. Data on the role of the Mini Mental State Examination (MMSE) and apolipoprotein E (APOE) in survival are sparse except for Alzheimer’s disease (AD). Methods: We studied mortality of 3,581 patients in an academic clinic from 1993 to 2004. Average follow-up was 4.1 years. We studied patients with amyotrophic lateral sclerosis (ALS) (n = 174), possible AD (n = 206), probable AD (n = 1,175), Parkinson’s disease (PD) (n = 661), mild cognitive impairment (MCI) (n = 357), frontotemporal dementia (FTD) (n = 94), Lewy body disease (LBD) (n = 64), and controls (n = 850). We compared patients’ mortality to the US population and to controls. Results: Mortality ranged from 7% for controls to 58% for ALS patients. The median survival times from initial visit for PD, FTD, probable AD, possible AD, LBD, and ALS were 8.9, 7.0, 5.9, 5.6, 5.3, and 2.7 years, respectively. Mortality rate ratios comparing each disease to controls were 39.43, 7.25, 3.70, 3.51, 2.47, 2.73, and 1.61 for ALS, FTD, LBD, PD, probable AD, possible AD, and MCI, respectively. A lower initial MMSE score was associated with higher mortality for probable AD, PD, and MCI, while APOE4 predicted mortality for PD and LBD. Non-whites had 20% lower mortality rates than whites for all dementias combined, adjusting for education. Conclusions: All neurologic diseases, including MCI, had increased mortality versus controls. A lower MMSE score and APOE4 presence predicted higher mortality for some patient groups.

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“…Some prognostic methods have been previously described for predicting mortality in patients with dementia. Most of these tools, however, were validated in specific populations such as patients living in nursing homes [7], or required laboratory data [8], or investigated only a single functional component of the patients [9]. Recently, a Multidimensional Prognostic Index (MPI) for 1-year mortality derived from a standardized Comprehensive Geriatric Assessment (CGA) was developed and validated in two independent cohorts of elderly patients hospitalized for acute diseases or relapse of chronic diseases [10].…”

Section: Introductionmentioning

confidence: 99%

The Multidimensional Prognostic Index (MPI), Based on a Comprehensive Geriatric Assessment Predicts Short- and Long-Term Mortality in Hospitalized Older Patients with Dementia

Sancarlo

Paris

Cascavilla

et al. 2009

JAD

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Aim of this study was to evaluate the usefulness of a Multidimensional Prognostic Index (MPI) based on a Comprehensive Geriatric Assessment (CGA) for predicting mortality risk in older patients with dementia. The present was a retrospective study with a year of follow-up that included 262 patients aged 65 years and older with a diagnosis of dementia. A standardized CGA that included information on clinical, cognitive, functional, and nutritional aspects, as well as comorbidity, medications, and social support network, was used to calculate MPI. The predictive value of the MPI for all-cause mortality over 1 month, 6 months, and 12 months of follow-up was evaluated. Higher MPI values were significantly associated with higher mortality at 1 month (MPI-1, low risk = 0%, MPI-2, moderate risk = 5.2%, MPI-3, severe risk = 13.7%; p < 0.002), 6-months (MPI-1 = 2.7%, MPI-2 = 11.2%, MPI-3 = 28.8%; p < 0.001), and 12-months (MPI-1 = 2.7%, MPI-2 = 18.2%, MPI-3 = 35.6%; p < 0.001) of follow-up. The discrimination of the MPI was also good, with areas under the ROC curves of 0.77 (sensitivity = 82.9%, specificity = 66.0%, with a cut off value > 0.16) at 12-months of follow up. In conclusion, the MPI, calculated from information collected in a standardized CGA, accurately stratified hospitalized elderly patients with dementia into groups at varying risk of shortand long-term mortality.

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Level of Cognitive Impairment Predicts Mortality in High-Risk Community Samples: The Memory and Medical Care Study

Cited by 18 publications

References 13 publications

The Association Between Geriatric Syndromes and Survival

The Association Between Geriatric Syndromes and Survival

Factors Affecting Survival of Patients with Neurodegenerative Disease

The Multidimensional Prognostic Index (MPI), Based on a Comprehensive Geriatric Assessment Predicts Short- and Long-Term Mortality in Hospitalized Older Patients with Dementia

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