Wu Chen-Yi, Chou Yi-Chang, Huang Nicole, Chou Yiing-Jenq, Hu Hsiao-Yun, Li Chung-Pin
Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Department of Dermatology, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.
Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
Prev Med. 2014 Oct;67:28-34. doi: 10.1016/j.ypmed.2014.06.027. Epub 2014 Jun 28.
To determine whether cognitive impairment assessed at annual geriatric health examinations is associated with increased mortality in the elderly.
This cohort study was based on data obtained from the government-sponsored Annual Geriatric Health Examination Program for the elderly in Taipei City between 2006 and 2010. The study sample consisted of 77,541 community-dwelling Taipei citizens aged 65 years or older. The Short Portable Mental Status Questionnaire (SPMSQ) was selected to measure cognitive impairment. Mortality was ascertained by matching cohort IDs with national death files.
There was a dose-response relationship between cognitive impairment and mortality (increased one score of SPMSQ, Hazard ratio [HR]: 1.12, 95% confidence interval [CI]: 1.10-1.14). Relative to no cognitive impairment, the HRs were 1.67 (95% CI: 1.43-1.94), 2.26 (95% CI: 1.90-2.70), and 2.68 (95% CI: 2.25-3.19) for mild, moderate, and severe cognitive impairments, respectively. The causes of death associated with cognitive impairment were circulatory, respiratory, and other causes, but not death from cancer.
Cognitive impairment as measured by the SPMSQ is associated with an increased risk for mortality. Even mild cognitive impairment was associated with greater risk of mortality at a relatively short follow-up time.
确定在年度老年健康检查中评估的认知障碍是否与老年人死亡率增加相关。
这项队列研究基于2006年至2010年期间从台北市政府资助的老年人年度老年健康检查计划中获得的数据。研究样本包括77541名年龄在65岁及以上的台北市社区居民。选择简短便携式精神状态问卷（SPMSQ）来测量认知障碍。通过将队列ID与国家死亡档案进行匹配来确定死亡率。
认知障碍与死亡率之间存在剂量反应关系（SPMSQ得分增加一分，风险比[HR]：1.12，95%置信区间[CI]：1.10 - 1.14）。相对于无认知障碍，轻度、中度和重度认知障碍的HR分别为1.67（95%CI：1.43 - 1.94）、2.26（95%CI：1.90 - 2.70）和2.68（95%CI：2.25 - 3.19）。与认知障碍相关的死亡原因是循环系统、呼吸系统和其他原因，但不是癌症死亡。
用SPMSQ测量的认知障碍与死亡风险增加相关。即使是轻度认知障碍在相对较短的随访时间内也与更高的死亡风险相关。
