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Research article
Xiaoming Shi
Chinese Center for Disease Control and Prevention
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Cognitive impairment is a major contributor to mortality among the elderly. However, the trend between cognitive impairment and mortality with time is understudied. We aim to evaluate the differences in associations of cognitive impairment with all-cause mortality and explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China.
Methods: A total of 13906 and 13873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality.
Results: For the 2002-2008 and 2008-2014 cohorts, the total follow-up times were 55,277 and 53,267 person-years, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, severe cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.48 (95% confidence interval [CI], 1.39-1.57) in 2002-2008 cohort and 1.32 (95% CI, 1.25-1.41) in 2008-2014 cohort. The trend of cognitive impairment with risk of all-cause mortality decreased from 2002-2008 to 2008-2014 cohort. The association of cognitive impairment and mortality was decreased with age in the two cohorts.
Conclusions : Cognitive impairment evaluated by MMSE was associated with increased risk of mortality and the association decreased with the passage of time during the two 6-year cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.
Keywords
Aging, Cohort study, Cognitive impairment, Oldest old, Mortality
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Editorial decision: Accept
On 13 Jan, 2020
Editor assigned
On 10 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 09 Jan, 2020
Reviewer #2 agreed
On 06 Jan, 2020
Review #1 received
Received 06 Jan, 2020
Review #2 received
Received 06 Jan, 2020
Reviewer #1 agreed
On 31 Dec, 2019
Editor assigned
On 30 Dec, 2019
Reviewers invited
Invitations sent on 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
Version 1
Posted 14 Oct, 2019
No comments provided
Review #3 received
Received 21 Nov, 2019
Editorial decision: Major revision
On 21 Nov, 2019
Review #4 received
Received 21 Nov, 2019
Reviewer #4 agreed
On 08 Nov, 2019
Reviewer #3 agreed
On 06 Nov, 2019
Review #1 received
Received 05 Nov, 2019
Review #2 received
Received 03 Nov, 2019
Reviewer #2 agreed
On 30 Oct, 2019
Reviewer #1 agreed
On 25 Oct, 2019
Reviewers invited
Invitations sent on 17 Oct, 2019
Submission checks complete
On 08 Oct, 2019
Editor assigned
On 20 Sep, 2019
Editor invited
On 19 Sep, 2019
First submitted
On 17 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
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A new preprint design is coming!
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See the published version of this preprint at BMC Geriatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Xiaoming Shi
Chinese Center for Disease Control and Prevention
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Editorial decision: Accept
On 13 Jan, 2020
Editor assigned
On 10 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 09 Jan, 2020
Reviewer #2 agreed
On 06 Jan, 2020
Review #1 received
Received 06 Jan, 2020
Review #2 received
Received 06 Jan, 2020
Reviewer #1 agreed
On 31 Dec, 2019
Editor assigned
On 30 Dec, 2019
Reviewers invited
Invitations sent on 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
Version 1
Posted 14 Oct, 2019
No comments provided
Review #3 received
Received 21 Nov, 2019
Editorial decision: Major revision
On 21 Nov, 2019
Review #4 received
Received 21 Nov, 2019
Reviewer #4 agreed
On 08 Nov, 2019
Reviewer #3 agreed
On 06 Nov, 2019
Review #1 received
Received 05 Nov, 2019
Review #2 received
Received 03 Nov, 2019
Reviewer #2 agreed
On 30 Oct, 2019
Reviewer #1 agreed
On 25 Oct, 2019
Reviewers invited
Invitations sent on 17 Oct, 2019
Submission checks complete
On 08 Oct, 2019
Editor assigned
On 20 Sep, 2019
Editor invited
On 19 Sep, 2019
First submitted
On 17 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: Cognitive impairment is a major contributor to mortality among the elderly. However, the trend between cognitive impairment and mortality with time is understudied. We aim to evaluate the differences in associations of cognitive impairment with all-cause mortality and explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China.
Methods: A total of 13906 and 13873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality.
Results: For the 2002-2008 and 2008-2014 cohorts, the total follow-up times were 55,277 and 53,267 person-years, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, severe cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.48 (95% confidence interval [CI], 1.39-1.57) in 2002-2008 cohort and 1.32 (95% CI, 1.25-1.41) in 2008-2014 cohort. The trend of cognitive impairment with risk of all-cause mortality decreased from 2002-2008 to 2008-2014 cohort. The association of cognitive impairment and mortality was decreased with age in the two cohorts.
Conclusions : Cognitive impairment evaluated by MMSE was associated with increased risk of mortality and the association decreased with the passage of time during the two 6-year cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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