Duff Kevin, Mold James W, Gidron Yori
University of Iowa, Iowa City, IA, USA.
J Clin Exp Neuropsychol. 2009 Jan;31(1):90-5. doi: 10.1080/13803390801998664. Epub 2008 May 2.
Prior studies of aging have identified a number of predictors of survival, including performances on some cognitive-functioning tests. However, few studies have used a multidomain test battery to identify which specific cognitive abilities predict death. The current study examined the 12 subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to see which subtests predicted death in a sample of 796 older, primary care patients. After 4 years, 98 individuals died, and 698 individuals remained alive. The individuals who died performed more poorly at baseline on 9 of the 12 RBANS subtests (p < .05) than did their peers who remained alive. In a multivariate analysis, however, only the RBANS Coding subtest independently predicted death (p < .001), along with male gender and greater initial medical comorbidity. Although the mechanism of poorer cognition and impending death remains unclear, some possibilities are discussed (e.g., brain dysfunction, poor medical compliance, impaired cellular immunity).
先前关于衰老的研究已经确定了一些生存预测因素，包括一些认知功能测试的表现。然而，很少有研究使用多领域测试组合来确定哪些特定的认知能力可以预测死亡。当前的研究对可重复神经心理状态评估量表（RBANS）的12个分测验进行了检验，以确定在796名老年初级保健患者样本中哪些分测验能够预测死亡。4年后，98人死亡，698人存活。死亡者在基线时，12个RBANS分测验中的9个表现比存活的同龄人更差（p < .05）。然而，在多变量分析中，只有RBANS编码分测验独立预测死亡（p < .001），同时还有男性性别和更高的初始医疗合并症。尽管认知能力较差与即将死亡之间的机制尚不清楚，但文中讨论了一些可能性（例如，脑功能障碍、医疗依从性差、细胞免疫受损）。
