Rush Alzheimer's Disease Center 600 S. Paulina, Suite 1020B, Chicago, IL 60612, USA. Patricia_Boyle @ rush.edu
Neuroepidemiology. 2013;40(4):247-52. doi: 10.1159/000342781. Epub 2013 Jan 24.
Decision making is thought to be an important determinant of health and well-being across the lifespan, but little is known about the association of decision making with mortality.
Participants were 675 older persons without dementia from the Rush Memory and Aging Project, a longitudinal cohort study of aging. Baseline assessments of decision making were used to predict the risk of mortality during up to 4 years of follow-up.
The mean score on the decision making measure at baseline was 7.1 (SD = 2.9, range: 0-12), with lower scores indicating poorer decision making. During up to 4 years of follow-up (mean = 1.7 years), 40 (6% of 675) persons died. In a proportional hazards model adjusted for age, sex and education, the risk of mortality increased by about 20% for each additional decision making error (HR = 1.19, 95% CI = 1.07-1.32, p = 0.002). Thus, a person who performed poorly on the measure of decision making (score = 3, 10th percentile) was about 4 times more likely to die compared to a person who performed well (score = 11, 90th percentile). Further, the association of decision making with mortality persisted after adjustment for the level of cognitive function.
Poor decision making is associated with an increased risk of mortality in old age even after accounting for cognitive function.
决策被认为是影响整个生命周期健康和幸福的重要决定因素，但人们对决策与死亡率之间的关系知之甚少。
参与者是来自拉什记忆与衰老项目的 675 名无痴呆的老年人，这是一项关于衰老的纵向队列研究。使用决策制定的基线评估来预测在长达 4 年的随访期间的死亡风险。
基线时决策制定措施的平均得分为 7.1（SD=2.9，范围：0-12），得分越低表示决策能力越差。在长达 4 年的随访期间（平均 1.7 年），40 人（675 人的 6%）死亡。在调整年龄、性别和教育的比例风险模型中，每增加一个决策错误，死亡风险增加约 20%（HR=1.19，95%CI=1.07-1.32，p=0.002）。因此，在决策制定衡量标准上表现不佳的人（得分=3，第 10 个百分位）比表现良好的人（得分=11，第 90 个百分位）死亡的可能性高约 4 倍。此外，即使在考虑认知功能水平后，决策与死亡率之间的关联仍然存在。
即使在考虑认知功能水平后，较差的决策制定与老年人的死亡风险增加有关。
