Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study
ObjectiveCognitive 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 cardiovascu...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.908120/full |
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| author | Zhiqiang Li Zhiqiang Li Xinran Gong Xinran Gong Shengshu Wang Shengshu Wang Miao Liu Shaohua Liu Yanding Wang Yanding Wang Di Wu Di Wu Meitao Yang Meitao Yang Rongrong Li Haowei Li Xuehang Li Shimin Chen Xiushan Zhang Ruizhong Jia Jinpeng Guo Yao He Yao He Yong Wang Yong Wang |
| author_facet | Zhiqiang Li Zhiqiang Li Xinran Gong Xinran Gong Shengshu Wang Shengshu Wang Miao Liu Shaohua Liu Yanding Wang Yanding Wang Di Wu Di Wu Meitao Yang Meitao Yang Rongrong Li Haowei Li Xuehang Li Shimin Chen Xiushan Zhang Ruizhong Jia Jinpeng Guo Yao He Yao He Yong Wang Yong Wang |
| author_sort | Zhiqiang Li |
| collection | DOAJ |
| description | ObjectiveCognitive 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 resultsA 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.ConclusionThese 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. |
| first_indexed | 2024-04-11T13:54:30Z |
| format | Article |
| id | doaj.art-0f8b3c7d63374852aa56681aadfaef27 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-11T13:54:30Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-0f8b3c7d63374852aa56681aadfaef272022-12-22T04:20:24ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-11-011010.3389/fpubh.2022.908120908120Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up studyZhiqiang Li0Zhiqiang Li1Xinran Gong2Xinran Gong3Shengshu Wang4Shengshu Wang5Miao Liu6Shaohua Liu7Yanding Wang8Yanding Wang9Di Wu10Di Wu11Meitao Yang12Meitao Yang13Rongrong Li14Haowei Li15Xuehang Li16Shimin Chen17Xiushan Zhang18Ruizhong Jia19Jinpeng Guo20Yao He21Yao He22Yong Wang23Yong Wang24School of Public Health, China Medical University, Shenyang, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaSchool of Public Health, China Medical University, Shenyang, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Healthcare, Agency for Offices Administration, Central Military Commission, Beijing, ChinaDepartment of Epidemiology and Statistics, Graduate School of Chinese PLA General Hospital, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaSchool of Public Health, China Medical University, Shenyang, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaSchool of Public Health, China Medical University, Shenyang, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaSchool of Public Health, China Medical University, Shenyang, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaBeijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, ChinaState Key Laboratory of Kidney Diseases, Department of Epidemiology, Chinese People's Liberation Army General Hospital, Beijing, ChinaSchool of Public Health, China Medical University, Shenyang, ChinaChinese People's Liberation Army Center for Disease Control and Prevention, Beijing, ChinaObjectiveCognitive 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 resultsA 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.ConclusionThese 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.https://www.frontiersin.org/articles/10.3389/fpubh.2022.908120/fullcognitive impairmentolder adultsMMSEmortalityfollow-up |
| spellingShingle | Zhiqiang Li Zhiqiang Li Xinran Gong Xinran Gong Shengshu Wang Shengshu Wang Miao Liu Shaohua Liu Yanding Wang Yanding Wang Di Wu Di Wu Meitao Yang Meitao Yang Rongrong Li Haowei Li Xuehang Li Shimin Chen Xiushan Zhang Ruizhong Jia Jinpeng Guo Yao He Yao He Yong Wang Yong Wang Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study Frontiers in Public Health cognitive impairment older adults MMSE mortality follow-up |
| 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 | cognitive impairment older adults MMSE mortality follow-up |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.908120/full |
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