Li Shangjie, He Xiuping, Wu Liang, Tang Xinming, Ouyang Yijiang, Jing Wenyuan, Yang Ya, Yang Jiacheng, Che Kechun, Pan Congcong, Chen Xiaoting, Zhang Xiaoxia, Zheng Xueting, Xu Jiahao, Liao Shaobin, Yin Mingjuan, Ni Jindong
Shunde Women and Children's Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China.
Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China.
Front Aging Neurosci. 2024 Jun 12;16:1419235. doi: 10.3389/fnagi.2024.1419235. eCollection 2024.
The association of cognitive function, its changes, and all-cause mortality has not reached a consensus, and the independence of the association between changes in cognitive function and mortality remains unclear. The purpose of this study was to evaluate the longitudinal association between baseline cognitive function and cognitive changes over 1 year with subsequent all-cause mortality among the older adults aged 60 and above.
A prospective cohort study utilizing the Community Older Adults Health Survey data. Initiated in 2018, the study annually assessed all individuals aged 60+ in Dalang Town, Dongguan City. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). A total of 6,042 older adults individuals were included, and multivariate Cox proportional hazard models were used to examine cognitive function's impact on mortality.
Participants' median age was 70 years, with 39% men. Over a median 3.08-year follow-up, 525 died. Mortality risk increased by 6% per MMSE score decrease (adjusted = 1.06, 95%: 1.05-1.08). Compared to those with normal cognitive function at baseline, participants with mild cognitive impairment and moderate to severe cognitive impairment had significantly higher mortality risks (adjusted = 1.40, 95%: 1.07-1.82; = 2.49, 95%: 1.91-3.24, respectively). The risk of death was 5% higher for each one-point per year decrease in cognitive function change rate ( = 1.05, 95%CI: 1.02-1.08). Compared with participants with stable cognitive function, those with rapid cognitive decline had a 79% increased risk of death (adjusted = 1.79, 95% : 1.11-2.87), with baseline cognitive function influencing this relationship significantly ( for interaction = 0.002).
Baseline cognitive impairment and rapid cognitive decline are associated with higher all-cause mortality risks in Chinese older adults. Baseline function influences the mortality impact of cognitive changes.
认知功能及其变化与全因死亡率之间的关联尚未达成共识，认知功能变化与死亡率之间关联的独立性仍不明确。本研究的目的是评估60岁及以上老年人基线认知功能和1年内认知变化与随后全因死亡率之间的纵向关联。
一项利用社区老年人健康调查数据的前瞻性队列研究。该研究于2018年启动，每年对东莞市大朗镇所有60岁及以上的个体进行评估。使用中文版简易精神状态检查表（MMSE）评估认知功能。共纳入6042名老年人，采用多变量Cox比例风险模型来检验认知功能对死亡率的影响。
参与者的年龄中位数为70岁，男性占39%。在中位3.08年的随访期内，525人死亡。MMSE评分每降低一分，死亡风险增加6%（校正后风险比=1.06，95%置信区间：1.05-1.08）。与基线认知功能正常的参与者相比，轻度认知障碍和中度至重度认知障碍的参与者死亡风险显著更高（校正后风险比分别为1.40，95%置信区间：1.07-1.82；2.49，95%置信区间：1.91-3.24）。认知功能变化率每年每降低一分，死亡风险高5%（风险比=1.05，95%置信区间：1.02-1.08）。与认知功能稳定的参与者相比，认知功能快速下降的参与者死亡风险增加79%（校正后风险比=1.79，95%置信区间：1.11-2.87），基线认知功能对这种关系有显著影响（交互作用P值=0.0
