Department of Neurology, Korea University Medical College and Korea University Ansan Hospital, Ansan, Korea.
Acta Psychiatr Scand. 2013 Apr;127(4):298-304. doi: 10.1111/j.1600-0447.2012.01918.x. Epub 2012 Aug 17.
Because the number of elderly is increasing worldwide, cognitive dysfunction becomes important health care issue. This study investigated the association between cognitive dysfunction and mortality in the elderly.
Data were analyzed from a longitudinal mortality follow-up study of 2712 Korean elderly aged 60 and over, examined in 2002 with complete data followed an average 6.03 years. Measurements included socio-demographic and clinical factors and Mini-Mental State Examination (MMSE). MMSE was categorized into groups with no, mild, or moderate cognitive dysfunction, and the subscores of MMSE domains were categorized into no dysfunction or dysfunction. The Cox proportional hazards models were conducted to examine the association between MMSE score and mortality, after adjusting for age, gender, education and other socio-demographic factors.
Death during follow-up occurred in 318 subjects. The mortality risk was significantly associated with the elderly with mild cognitive dysfunction [hazard ratio (HR) = 1.93] and with moderate cognitive dysfunction (HR = 2.66). 'Orientation-to-time' (HR = 1.39) and 'Attention' (HR = 1.48) domains of MMSE were independently associated with mortality.
This study showed that cognitive dysfunction independently predicted mortality in the elderly. Cognitive dysfunction should be considered part of identifying the elderly at high risk for mortality.
由于全球老年人口数量不断增加,认知功能障碍成为了一个重要的医疗保健问题。本研究旨在探讨老年人认知功能障碍与死亡率之间的关系。
本研究对 2712 名年龄在 60 岁及以上的韩国老年人进行了纵向死亡率随访研究,这些老年人在 2002 年接受了全面检查,平均随访 6.03 年。研究中测量了社会人口学和临床因素以及简易精神状态检查(MMSE)的评分。将 MMSE 评分分为无认知功能障碍、轻度认知功能障碍和中度认知功能障碍组,并将 MMSE 各领域的子评分分为无功能障碍和功能障碍组。采用 Cox 比例风险模型,在调整了年龄、性别、教育程度等社会人口学因素后,对 MMSE 评分与死亡率之间的关系进行了分析。
在随访期间,有 318 名受试者死亡。轻度认知功能障碍(HR=1.93)和中度认知功能障碍(HR=2.66)的老年人的死亡风险显著升高。MMSE 的“时间定向”(HR=1.39)和“注意力”(HR=1.48)领域与死亡率独立相关。
本研究表明,认知功能障碍独立预测了老年人的死亡率。认知功能障碍应被视为识别高死亡率老年人群的一部分。