Decline in cognitive and functional skills increases mortality risk in nondemented elderly
Decline in cognitive and functional skills increases mortality risk in nondemented elderly
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DOI：
10.1212/01.wnl.0000180970.07386.cb
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发表时间：
2005-10-25
期刊：
影响因子：
9.9
通讯作者：
Mayeux, R
中科院分区：
文献类型：
--
作者：
Schupf, N;Tang, MX;Mayeux, R
目的：探讨非痴呆老年人认知和功能/身体能力下降率与死亡风险之间的关系。研究方法：数据来自于一项关于老年和痴呆的前瞻性研究，研究对象为居住在北方曼哈顿的65岁及以上的老年人。作者纳入了该队列的878名成员，他们在三个研究间隔内测量了记忆、认知、语言或功能评分，排除了所有患有痴呆症或基线时在日常生活活动（ADL）技能方面存在一个以上问题的参与者。根据认知和功能/身体因素的变化斜率，参与者被分类为没有下降、缓慢、中等或快速下降。作者使用生存方法研究了年轻和老年非痴呆老年人以及三个种族群体中认知和功能表现下降率与随后死亡率的关系，并对潜在的混杂因素进行了调整。结果如下：非痴呆老年人与保存ADL技能谁表现出快速下降的措施，视觉空间推理/认知，语言，ADL，和工具ADL功能的两倍，可能会死亡的非痴呆老年人没有下降或下降速度较慢，而在内存或四肢活动度的措施下降率与死亡风险无关。死亡风险下降率与死亡风险的关联在相对年轻的人中更强（
Objective: To investigate the relation between rate of decline in cognitive and functional/ physical abilities and risk of death in nondemented elderly. Methods: Data were included from individuals participating in a prospective study of aging and dementia in Medicare recipients, 65 years and older, residing in northern Manhattan. The authors included 878 members of the cohort who had measures of memory, cognitive, language, or functional scores over three study intervals, excluding all participants who were demented or had more than one problem in activity of daily living (ADL) skills at baseline. Participants were classified as showing no decline, slow, medium, or rapid rate of decline, based on the slope of change in cognitive and functional/ physical factors. The authors used survival methods to examine the relation of rate of decline in cognitive and functional performance to subsequent mortality in younger and older nondemented elderly and across three ethnic groups, adjusting for potential confounders. Results: Nondemented elderly with preserved ADL skills who showed rapid rates of decline on measures of visuospatial reasoning/cognitive, language, ADL, and instrumental ADL functions were approximately twice as likely to die as nondemented elderly who showed no decline or slower rates of decline, while rate of decline in memory or in measures of extremity mobility was not related to risk of death. The association of the rate of decline to risk of death was stronger in relatively young (