Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China
Abstract Background Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the...
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doaj-0481e132e62b47ebb35ad452020229102021-01-31T12:18:01ZengBMCBMC Geriatrics1471-23182020-01-012011910.1186/s12877-020-1424-4Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in ChinaJun Duan0Yue-Bin Lv1Xiang Gao2Jin-Hui Zhou3Virginia Byers Kraus4Yi Zeng5Hong Su6Xiao-Ming Shi7Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical UniversityNational Institute of Environmental Health, Chinese Center for Disease Control and PreventionNutritional Epidemiology Lab, Pennsylvania State UniversityNational Institute of Environmental Health, Chinese Center for Disease Control and PreventionDuke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of MedicineCenter for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Anhui Medical UniversityNational Institute of Environmental Health, Chinese Center for Disease Control and PreventionAbstract Background Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and further explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. Methods A total of 13,906 and 13,873 Chinese elderly aged 65 years and older were included in the 2002–2008 and 2008–2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality. Results For the 2002–2008 and 2008–2014 cohorts, 55,277 and 53,267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25–1.39) in 2002–2008 cohort and 1.26 (95% CI, 1.19–1.32) in 2008–2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002 to 2008 to 2008–2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts. Conclusions Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65–79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.https://doi.org/10.1186/s12877-020-1424-4AgingCohort studyCognitive impairmentOldest oldMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jun Duan Yue-Bin Lv Xiang Gao Jin-Hui Zhou Virginia Byers Kraus Yi Zeng Hong Su Xiao-Ming Shi |
spellingShingle |
Jun Duan Yue-Bin Lv Xiang Gao Jin-Hui Zhou Virginia Byers Kraus Yi Zeng Hong Su Xiao-Ming Shi Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China BMC Geriatrics Aging Cohort study Cognitive impairment Oldest old Mortality |
author_facet |
Jun Duan Yue-Bin Lv Xiang Gao Jin-Hui Zhou Virginia Byers Kraus Yi Zeng Hong Su Xiao-Ming Shi |
author_sort |
Jun Duan |
title |
Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China |
title_short |
Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China |
title_full |
Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China |
title_fullStr |
Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China |
title_full_unstemmed |
Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China |
title_sort |
association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in china |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2020-01-01 |
description |
Abstract Background Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and further explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. Methods A total of 13,906 and 13,873 Chinese elderly aged 65 years and older were included in the 2002–2008 and 2008–2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality. Results For the 2002–2008 and 2008–2014 cohorts, 55,277 and 53,267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25–1.39) in 2002–2008 cohort and 1.26 (95% CI, 1.19–1.32) in 2008–2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002 to 2008 to 2008–2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts. Conclusions Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65–79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted. |
topic |
Aging Cohort study Cognitive impairment Oldest old Mortality |
url |
https://doi.org/10.1186/s12877-020-1424-4 |
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