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Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study
OBJECTIVE: Cognitive impairment (CI) has been demonstrated as a useful proxy measure of mortality in Western populations. However, the predictive value of CI in Chinese populations is unknown. We aimed to explore whether CI is independently associated with increased long-term all-cause and cardiovas...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744251/ https://www.ncbi.nlm.nih.gov/pubmed/36518570 http://dx.doi.org/10.3389/fpubh.2022.908120 |
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author | Li, Zhiqiang Gong, Xinran Wang, Shengshu Liu, Miao Liu, Shaohua Wang, Yanding Wu, Di Yang, Meitao Li, Rongrong Li, Haowei Li, Xuehang Chen, Shimin Zhang, Xiushan Jia, Ruizhong Guo, Jinpeng He, Yao Wang, Yong |
author_facet | Li, Zhiqiang Gong, Xinran Wang, Shengshu Liu, Miao Liu, Shaohua Wang, Yanding Wu, Di Yang, Meitao Li, Rongrong Li, Haowei Li, Xuehang Chen, Shimin Zhang, Xiushan Jia, Ruizhong Guo, Jinpeng He, Yao Wang, Yong |
author_sort | Li, Zhiqiang |
collection | PubMed |
description | OBJECTIVE: Cognitive impairment (CI) has been demonstrated as a useful proxy measure of mortality in Western populations. However, the predictive value of CI in Chinese populations is unknown. We aimed to explore whether CI is independently associated with increased long-term all-cause and cardiovascular disease (CVD) mortality in Chinese older adults and the association of performance in specific MMSE sub-domains to subsequent mortality. METHODS AND RESULTS: A total of 4,499 older adults [mean (SD) age, 70.3(6.7) years] who received a sample investigation from 2011 to 2014 were followed up till 2021 for mortality. The Mini-Mental State Examination was used to assess cognitive function, and Cox's proportional hazard models were used to evaluate the effects of cognitive function on the risk of all-cause and CVD mortality. Demographic characteristics, lifestyle, and health status were included as covariates. During a 10-year follow-up, a total of 667 (14.8%) died. In the fully adjusted model, compared with cognitively normal participants with CI had a 1.33-fold [HR, 1.33; (95% CI, 1.10–1.61)] greater risk of all-cause mortality and a 1.45-fold [HR, 1.45; (95% CIs, 1.11–1.92)] greater risk of CVD mortality. After a similar multivariable adjustment, a per-SD increase in MMSE scores was associated with a reduced risk of all-cause mortality [HR, 0.85; (95% CI, 0.78–0.93)] and CVD mortality [HR, 0.74; (95% CI, 0.65–0.84)]. In the unadjusted model, MMSE sub-domains (apart from immediate recall) were associated with mortality. But only orientation and calculation and attention were still independently associated with all-cause and CVD mortality in a multivariable model. CONCLUSION: These findings confirmed that CI is a marker of all-cause and CVD mortality risk in Chinese older adults, independently of other commonly assessed risk factors, and some sub-domains of the MMSE may have stronger associations with mortality. Further research is needed to identify the mechanisms underlying the observed associations. |
format | Online Article Text |
id | pubmed-9744251 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97442512022-12-13 Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study Li, Zhiqiang Gong, Xinran Wang, Shengshu Liu, Miao Liu, Shaohua Wang, Yanding Wu, Di Yang, Meitao Li, Rongrong Li, Haowei Li, Xuehang Chen, Shimin Zhang, Xiushan Jia, Ruizhong Guo, Jinpeng He, Yao Wang, Yong Front Public Health Public Health OBJECTIVE: Cognitive impairment (CI) has been demonstrated as a useful proxy measure of mortality in Western populations. However, the predictive value of CI in Chinese populations is unknown. We aimed to explore whether CI is independently associated with increased long-term all-cause and cardiovascular disease (CVD) mortality in Chinese older adults and the association of performance in specific MMSE sub-domains to subsequent mortality. METHODS AND RESULTS: A total of 4,499 older adults [mean (SD) age, 70.3(6.7) years] who received a sample investigation from 2011 to 2014 were followed up till 2021 for mortality. The Mini-Mental State Examination was used to assess cognitive function, and Cox's proportional hazard models were used to evaluate the effects of cognitive function on the risk of all-cause and CVD mortality. Demographic characteristics, lifestyle, and health status were included as covariates. During a 10-year follow-up, a total of 667 (14.8%) died. In the fully adjusted model, compared with cognitively normal participants with CI had a 1.33-fold [HR, 1.33; (95% CI, 1.10–1.61)] greater risk of all-cause mortality and a 1.45-fold [HR, 1.45; (95% CIs, 1.11–1.92)] greater risk of CVD mortality. After a similar multivariable adjustment, a per-SD increase in MMSE scores was associated with a reduced risk of all-cause mortality [HR, 0.85; (95% CI, 0.78–0.93)] and CVD mortality [HR, 0.74; (95% CI, 0.65–0.84)]. In the unadjusted model, MMSE sub-domains (apart from immediate recall) were associated with mortality. But only orientation and calculation and attention were still independently associated with all-cause and CVD mortality in a multivariable model. CONCLUSION: These findings confirmed that CI is a marker of all-cause and CVD mortality risk in Chinese older adults, independently of other commonly assessed risk factors, and some sub-domains of the MMSE may have stronger associations with mortality. Further research is needed to identify the mechanisms underlying the observed associations. Frontiers Media S.A. 2022-11-28 /pmc/articles/PMC9744251/ /pubmed/36518570 http://dx.doi.org/10.3389/fpubh.2022.908120 Text en Copyright © 2022 Li, Gong, Wang, Liu, Liu, Wang, Wu, Yang, Li, Li, Li, Chen, Zhang, Jia, Guo, He and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Li, Zhiqiang Gong, Xinran Wang, Shengshu Liu, Miao Liu, Shaohua Wang, Yanding Wu, Di Yang, Meitao Li, Rongrong Li, Haowei Li, Xuehang Chen, Shimin Zhang, Xiushan Jia, Ruizhong Guo, Jinpeng He, Yao Wang, Yong Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study |
title | Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study |
title_full | Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study |
title_fullStr | Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study |
title_full_unstemmed | Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study |
title_short | Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study |
title_sort | cognitive impairment assessed by mini-mental state examination predicts all-cause and cvd mortality in chinese older adults: a 10-year follow-up study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744251/ https://www.ncbi.nlm.nih.gov/pubmed/36518570 http://dx.doi.org/10.3389/fpubh.2022.908120 |
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