From the Department of Neurology (J.B.-L., J.P.R., F.B.-P.), University Hospital 12 de Octubre, Madrid; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (J.B.-L., F.B.-P.); Department of Medicine (J.B.-L., F.B.-P.), Complutense University, Madrid, Spain; G.H. Sergievsky Center (E.D.L.), Department of Neurology (E.D.L.), and Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.L.), College of Physicians and Surgeons, and Department of Epidemiology (E.D.L.), Mailman School of Public Health, Columbia University, New York.
Neurology. 2014 Apr 22;82(16):1441-8. doi: 10.1212/WNL.0000000000000350. Epub 2014 Apr 9.
To assess whether faster cognitive decline in elders without dementia is associated with decreased risk of cancer mortality.
In this population-based, prospective study of 2,627 people without dementia aged 65 years and older (Neurological Disorders in Central Spain), a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered at 2 visits (baseline and follow-up, approximately 3 years later). We divided change in 37-MMSE into tertiles (lower tertile ≥ 2 point improvement in score, higher tertile ≥ 2 point decline in score). Community-dwelling elders were followed for a median of 12.9 years, after which the death certificates of those who died were examined.
A total of 1,003 (38.2%) died, including 339 (33.8%) deaths among participants who were in the higher tertile of 37-MMSE change and 664 (66.2%) deaths among those in the remaining tertiles. Cancer was reported significantly less often in those in the higher tertile of MMSE change (20.6%) than in those in the remaining tertiles (28.6%): in an unadjusted Cox model, hazard ratio for cancer mortality in participants within the higher tertile = 0.75 (p = 0.04) compared with the participants within the remaining tertiles. In a Cox model that adjusted for a variety of demographic factors and comorbidities, hazard ratio for cancer mortality in participants within the higher tertile = 0.70 (p = 0.01).
In this population-based, prospective study of community-dwelling elders without dementia, faster cognitive decline was associated with a decreased risk of cancer mortality. Further studies are required to elucidate this inverse association in elders without dementia.
评估认知能力在无痴呆老年人中衰退较快是否与癌症死亡率降低有关。
在这项基于人群的、对 2627 名年龄在 65 岁及以上（西班牙中部神经紊乱研究）、无痴呆的老年人进行的前瞻性研究中，在两次就诊时（基线和随访，大约 3 年后）进行了 37 项简短精神状态检查（37-MMSE）的评估。我们将 37-MMSE 的变化分为三分位（较低三分位≥评分提高 2 分，较高三分位≥评分下降 2 分）。对居住在社区的老年人进行了中位数为 12.9 年的随访，之后检查了死亡者的死亡证明。
共有 1003 人（38.2%）死亡，其中 339 人（33.8%）处于 37-MMSE 变化较高三分位，664 人（66.2%）处于其余三分位。在调整了各种人口统计学因素和合并症的 Cox 模型中，较高三分位 MMSE 变化参与者的癌症死亡率风险比为 0.70（p=0.01）。
在这项基于人群的、对无痴呆居住在社区的老年人进行的前瞻性研究中，认知能力较快衰退与癌症死亡率降低有关。需要进一步的研究来阐明无痴呆老年人中这种相反的关联。
