Takata Yutaka, Ansai Toshihiro, Soh Inho, Awano Shuji, Nakamichi Ikuo, Akifusa Sumio, Goto Kenichi, Yoshida Akihiro, Fujii Hiroki, Fujisawa Ritsuko, Sonoki Kazuo
Division of General Internal Medicine, Kyushu Dental University, Kitakyushu, Japan.
Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan.
Clin Interv Aging. 2014 Oct 7;9:1691-9. doi: 10.2147/CIA.S64107. eCollection 2014.
The relationship between mortality and impaired cognitive function has not been thoroughly investigated in a very elderly community-dwelling population, and little is known about the association of disease-specific mortality with Mini-Mental State Examination (MMSE) subscale scores. Here we evaluated these data in Japanese community-dwelling elderly. In 2003, 85 year-olds (n=207) were enrolled; 205 completed the MMSE for cognitive function and were followed-up for 10 years, during which time 120 participants died, 70 survived, and 17 were lost to follow-up. Thirty-eight deaths were due to cardiovascular disease, 22 to senility, 21 to respiratory disease, and 16 to cancer. All-cause mortality decreased by 4.3% with a 1-point increase in the global MMSE score without adjustment, and it decreased by 6.3% with adjustment for both sex and length of education. Cardiovascular mortality decreased by 7.6% and senility mortality decreased by 9.2% with a 1-point increase in the global MMSE score with adjustment for sex and education. No association was found between respiratory diseases or cancer mortality and global MMSE score. All-cause mortality also decreased with increases in MMSE subscale scores for time orientation, place orientation, delayed recall, naming objects, and listening and obeying. Cardiovascular mortality was also associated with the MMSE subscale of naming objects, and senility mortality was associated with the subscales of time orientation and place orientation. Thus, we found that impaired cognitive function determined by global MMSE score and some MMSE subscale scores were independent predictors of all-cause mortality or mortality due to cardiovascular disease or senility in 85 year-olds.
在高龄社区居住人群中，死亡率与认知功能受损之间的关系尚未得到充分研究，对于特定疾病死亡率与简易精神状态检查表（MMSE）各分量表得分之间的关联也知之甚少。在此，我们对日本社区居住老年人的这些数据进行了评估。2003年，招募了85岁的老年人（n = 207）；205人完成了用于认知功能评估的MMSE，并接受了10年的随访，在此期间，120名参与者死亡，70人存活，17人失访。38例死亡归因于心血管疾病，22例归因于衰老，21例归因于呼吸系统疾病，16例归因于癌症。在未进行调整的情况下，全球MMSE得分每增加1分，全因死亡率下降4.3%；在对性别和受教育年限进行调整后，全因死亡率下降6.3%。在对性别和教育进行调整后，全球MMSE得分每增加1分，心血管疾病死亡率下降7.
