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

Yu, Wan Chen; Chou, Ming Yueh; Peng, Li Ning; Lin, Yu Te; Liang, Chih‐Kuang; Chen, Liang Kung

doi:10.1371/journal.pone.0181741

Cited by 25 publications

(15 citation statements)

References 35 publications

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“…However, possible confounding might remain and attenuate the link. Other factors such as genes [39,42], physical disability [12], and frailty [31][32][33], which can lead to cognitive decline and mortality but that were not measured in the survey, can contribute to unmeasured confounding factors. The limitation of our study is that the decline of cognitive function was not controlled during the follow-up since cognitive functions were tested only in the beginning of the study.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

Tamošiūnas

Sapranaviciute-Zabazlajeva

Lukšienė

et al. 2020

IJERPH

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Background: The purpose of the study is to evaluate the association between cognitive function and risk of all-cause and cardiovascular disease mortality during 10 years of the follow-up. Methods: 7087 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008. During 10 years of follow-up, all-cause and CVD mortality risk were evaluated. Results: During 10 years of follow-up, 768 (23%) men and 403 (11%) women died (239 and 107 from CVD). After adjustment for sociodemographic, biological, lifestyle factors, and illnesses, a decrease per 1 standard deviation in different cognitive function scores increased risk for all-cause mortality (by 13%–24% in men, and 17%–33% in women) and CVD mortality (by 19%–32% in men, and 69%–91% in women). Kaplan-Meier survival curves for all-cause and CVD mortality, according to tertiles of cognitive function, revealed that the lowest cognitive function (1st tertile) predicts shorter survival compared to second and third tertiles (p < 0.001). Conclusions: The findings of this follow-up study suggest that older participants with lower cognitive functions have an increased risk for all-cause and CVD mortality compared to older participants with a higher level of cognitive function.

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Section: Discussionmentioning

confidence: 99%

“…As scientists put it, complaints about cognitive abilities do not ultimately lead to cognitive impairment in all cases [10,11]. Some authors stated that cognitive impairment does not affect mortality without physical disability [12].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

Tamošiūnas

Sapranaviciute-Zabazlajeva

Lukšienė

et al. 2020

IJERPH

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“…As adults age, many will develop mobility disability, mild cognitive impairment (MCI) or both. Individuals with motor or MCI are at an increased risk of death (1,2) and the effects on mortality are likely synergistic (3). Despite the wealth of prior work, the frequency and temporal relationship of incident mobility disability and MCI, as well as the extent to which the order of their occurrence may differentially affect an individual's subsequent risk of death have not been investigated.…”

Section: Introductionmentioning

confidence: 99%

Incident Mobility Disability, Mild Cognitive Impairment, and Mortality in Community-Dwelling Older Adults

Boyle

Leurgans

et al. 2019

Neuroepidemiology

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Background/Aims: Mobility disability and mild cognitive impairment (MCI) are common in aging and both are associated with risk of death. This study tested the hypothesis that risk of death differs by the order in which mobility disability and MCI occurred. Methods: 1,262 community-dwelling older adults were unimpaired at baseline and followed annually. Mobility disability was based on measured gait speed and MCI was based on cognitive performance tests. A multi-state Cox model simultaneously examined incidences of mobility disability and MCI to determine whether the order of their occurrence is differentially associated with risk of death. Results: The average age was 75.3 years and 70% were female. While mobility disability occurred more frequently than incident MCI, the subsequent risk of death was higher in participants who developed MCI alone compared to those who developed mobility disability alone (hazard ratio=1.70, P=0.018). Of the participants who initially developed mobility disability, about half subsequently developed MCI which doubled their risk of death (hazard ratio=2.17, P<0.001). By contrast, over two thirds who developed MCI subsequently developed mobility disability which did not further increase their risk of death. Conclusion: Mobility disability occurs more frequently in community-dwelling older adults, but MCI is more strongly associated with mortality.

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“…Therefore, there is growing interest in an emerging geriatric syndrome encompassed by concomitant declines in both cognitive and physical functioning. The presence of coexisting cognitive impairment and physical disability was associated with increased all-cause mortality in older men, but cognitive impairment without physical disability was not (16). Furthermore, physical activity has been shown to modify the association between multimorbidity and cognitive function (17).…”

mentioning

confidence: 99%

Multimorbidity and Cognitive Decline Over 14 Years in Older Americans

Wei

Levine

Zahodne

et al. 2019

The Journals of Gerontology: Series A

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Background Multimorbidity is associated with greater disability and accelerated declines in physical functioning over time in older adults. However, less is known about its effect on cognitive decline. Methods Participants without dementia from the Health and Retirement Study were interviewed about physician-diagnosed conditions, from which their multimorbidity-weighted index (MWI) that weights diseases to physical functioning was computed. We used linear mixed-effects models to examine the predictor MWI with the modified Telephone Interview for Cognitive Status (TICSm, global cognition), 10-word immediate recall and delayed recall, and serial 7s outcomes biennially after adjusting for baseline cognition and covariates. Results Fourteen thousand two hundred sixty-five participants, 60% female, contributed 73,700 observations. Participants had a mean ± SD age 67 ± 9.3 years and MWI 4.4 ± 3.9 at baseline. Each point increase in MWI was associated with declines in global cognition (0.04, 95% CI: 0.03–0.04 TICSm), immediate recall (0.01, 95% CI: 0.01–0.02 words), delayed recall (0.01, 95% CI: 0.01–0.02 words), and working memory (0.01, 95% CI: 0.01–0.02 serial 7s; all p < .001). Multimorbidity was associated with faster declines in global cognition (0.003 points/year faster, 95% CI: 0.002–0.004), immediate recall (0.001 words/year faster, 95% CI: 0.001–0.002), and working memory (0.006 incorrect serial 7s/year faster, 95% CI: 0.004–0.009; all p < .001), but not delayed recall compared with premorbid slopes. Conclusions Multimorbidity using a validated index weighted to physical functioning was associated with acute decline in cognition and accelerated and persistent cognitive decline over 14 years. This study supports an ongoing geriatric syndrome of coexisting physical and cognitive impairment in adults with multimorbidity. Clinicians should monitor and address both domains in older multimorbid adults.

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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

Cited by 25 publications

References 35 publications

Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

Incident Mobility Disability, Mild Cognitive Impairment, and Mortality in Community-Dwelling Older Adults

Multimorbidity and Cognitive Decline Over 14 Years in Older Americans

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