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BMC Psychiatry
Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Research article

Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults

Authors: Mu-Cyun Wang, Tsai-Chung Li, Chia-Ing Li, Chiu-Shong Liu, Chih-Hsueh Lin, Wen-Yuan Lin, Chuan-Wei Yang, Shing-Yu Yang, Cheng-Chieh Lin

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Cognitive impairment is accompanied with high rates of comorbid conditions, leading ultimately to death. Few studies examine the relation between cognitive transition and mortality, especially in Asian population. This study evaluated baseline cognition and cognitive transition in relation to all-cause mortality among community-dwelling older adults.

Methods

We conducted a community-based prospective cohort study among 921 participants of Taichung Community Health Study for Elders in 2009. Cognitive function was evaluated by the Mini-Mental State Examination. Cognitive impairment was considered if the total score is less than 27, 24, and 21 for a participant’s educational level of more than 6 years, equal or less than 6 years, and illiteracy, respectively. One-year transition in cognitive function was obtained among 517 individuals who were assessed in both 2009 and 2010. Mortality was followed up until 2016. Cox proportional hazards models were applied to estimate the adjusted hazard ratios of mortality for baseline cognitive impairment and one-year transition in cognitive status.

Results

After a follow-up of 6.62 years, 160 deaths were recorded. The multivariate adjusted hazard ratio (95% confidence interval) for baseline cognitive impairment was 2.08 (1.43, 3.01). Significantly increased mortality risk was observed for cognitively impaired–normal and impaired–impaired subgroups over 1 year as compared with those who remained normal [2.87 (1.25, 6.56) and 3.79 (1.64, 8.73), respectively]. The area under the receiver operating characteristic curves demonstrated that baseline cognition and one-year cognitive transition had no differential predictive ability for mortality. Besides, there was an interaction of cognitive impairment and frailty, with an additive mortality risk [5.41 (3.14, 9.35)] for the elders who presented with both.

Conclusion

Baseline cognitive impairment rather than one-year progression is associated with mortality in a six-year follow-up on older adults.
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Metadata
Title
Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults
Authors
Mu-Cyun Wang
Tsai-Chung Li
Chia-Ing Li
Chiu-Shong Liu
Chih-Hsueh Lin
Wen-Yuan Lin
Chuan-Wei Yang
Shing-Yu Yang
Cheng-Chieh Lin
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02618-9

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