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aging

Does faster cognitive decline predict death?

Lv X, Li W, Ma Y, et al. · BMC medicine · 2019

Open access · cc by · source: Europe PMC

Among 11,732 Chinese older adults, rapid MMSE decline (>1.62 points/year) tracked a 75% higher subsequent 3-year death risk after adjusting for baseline cognition.

Study at a glance

Design
Cohort — Two successive CLHLS cohorts; Cox models of MMSE decline vs 3-year mortality
N
N=11732 · Older adults with two consecutive MMSE exams; mean age 82.5 years
Population
Community-dwelling Chinese older adults in CLHLS
Outcome
All-cause mortality after cognitive-decline assessment interval

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Key findings

Mean age 82.5 years; 44.9% men. Faster MMSE decline monotonically associated with higher mortality. Rapid decliners had HR 1.75 (95% CI 1.57–1.95) vs stable cognition. Associations were stronger at ages 65–79 and with baseline MMSE ≥24, and were consistent across cohorts and sexes.

Methodology

Nested two non-overlapping CLHLS cohorts, measured Chinese MMSE twice, then used Cox models relating rate of MMSE change to the next 3 years of mortality while adjusting for sociodemographics, behaviours, comorbidities, and baseline MMSE.

Limitations

Observational CLHLS data cannot prove that slowing cognitive decline would prevent deaths; residual confounding and practice/measurement effects on MMSE remain possible.

How this study connects

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