Association of trajectories of cognitive function with cause‐specific mortality and medical and long‐term care costs
Association of trajectories of cognitive function with cause‐specific mortality and medical and long‐term care costs
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认知功能轨迹与特定原因死亡率以及医疗和长期护理费用的关联
DOI：
10.1111/ggi.13802
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发表时间：
2019
影响因子：
3.3
通讯作者：
Shinkai Shoji
中科院分区：
文献类型：
--
作者：
Taniguchi Yu;Kitamura Akihiko;Ishizaki Tatsuro;Fujiwara Yoshinori;Shinozaki Tomohiro;Seino Satoshi;Mitsutake Seigo;Suzuki Hiroyuki;Yokoyama Yuri;Abe Takumi;Ikeuchi Tomoko;Yokota Isao;Matsuyama Yutaka;Shinkai Shoji
认知能力下降通过痴呆相关途径增加死亡风险，并可能与医疗费用增加有关。使用长达12年的重复测量数据，我们确定了社区居住的日本老年人认知功能的轨迹。然后，我们研究这些轨迹是否与全因和原因特异性死亡率，以及医疗费用的差异。MethodsA共1736名年龄≥65岁的成年人，他们没有残疾痴呆症，在2002-2014年期间完成了年度评估。认知功能通过简易精神状态检查进行评估。随访评估的平均数量为3.9，观察总数为6824在随访period.ResultsWe确定了五个轨迹模式的认知功能（高，第二，第三，第四，低）在12年的随访期间。低（2.0%）和第四（2.2%）轨迹组的心血管疾病死亡率风险比更高，第三（16.8%）和第二（38.8%）轨迹组的其他原因死亡率风险比显著高于高轨迹组（40.3%）。直到5年的随访，两个低轨迹组的参与者平均每月医疗和长期护理费用较高。经过8年的随访，平均成本是最高的第三轨迹.ConclusionsThe心血管疾病的死亡风险较高的两个较低轨迹组的认知功能，他们显示出较高的医疗费用在第一个5年的后续行动。经过8年的随访，第三种轨迹的医疗费用最高，这可能是因为认知能力逐渐下降导致的住院治疗。Geriatr Gerontol Int 2019; 19：1236-1242。
AimCognitive decline increases mortality risk through dementia‐related pathways and might be associated with increased healthcare costs. Using up to 12 years of repeated measures data, we identified trajectories in cognitive function among community‐dwelling older Japanese adults. We then examined whether these trajectories were associated with all‐cause and cause‐specific mortality, and differences in healthcare costs.MethodsA total of 1736 adults aged ≥65 years who were free of disabling dementia completed annual assessments during 2002–2014. Cognitive function was assessed with the Mini‐Mental State Examination. The average number of follow‐up assessments was 3.9, and the total number of observations was 6824 during the follow‐up period.ResultsWe identified five trajectory patterns in cognitive function (high, second, third, fourth, and low) during the 12‐year follow‐up period. The low (2.0%) and fourth (2.2%) trajectory groups had higher hazard ratios for cardiovascular disease mortality, and hazard ratios for other cause mortality were significantly higher for the third (16.8%) and second (38.8%) trajectory groups than for the high trajectory group (40.3%). Until 5 years of follow up, participants in the two lower‐trajectory groups had higher mean combined monthly medical and long‐term care costs. After 8 years of follow up, mean costs were highest for the third trajectory.ConclusionsThe risk of death from cardiovascular disease was higher in the two lower‐trajectory groups in cognitive function, and they showed higher healthcare costs during the first 5 years of follow up. After 8 years of follow up, the third trajectory had the highest healthcare costs, perhaps because of hospitalizations attributable to gradual cognitive decline.Geriatr Gerontol Int 2019; 19: 1236–1242.