Mortality in Incident Cognitive Impairment: Results of the Prospective AgeCoDe Study. Issue 4 (19th December 2016)

• Record Type: Journal Article
• Authors: Luck, Tobias; Riedel‐Heller, Steffi G.; Roehr, Susanne; Wiese, Birgitt; van der Leeden, Carolin; Heser, Kathrin; Bickel, Horst; Pentzek, Michael; König, Hans‐Helmut; Werle, Jochen; Mamone, Silke; Mallon, Tina; Wolfsgruber, Steffen; Weeg, Dagmar; Fuchs, Angela; Brettschneider, Christian; Scherer, Martin; Maier, Wolfgang; Weyerer, Siegfried
• Other Names: van den Bussche Hendrik investigator.; Abholz Heinz‐Harald investigator.; Bachmann Cadja investigator.; Blank Wolfgang investigator.; Eifflaender‐Gorfer Sandra investigator.; Eisele Marion investigator.; Ernst Annette investigator.; Jessen Frank investigator.; Kaduszkiewicz Hanna investigator.; Kaufeler Teresa investigator.; Köhler Mirjam investigator.; Koppara Alexander investigator.; Lubisch Diana investigator.; Lühmann Dagmar investigator.; Luppa Melanie investigator.; Mayer Manfred investigator.; Mösch Edelgard investigator.; Prokein Jana investigator.; Schumacher Anna investigator.; Stein Janine investigator.; Steinmann Susanne investigator.; Tebarth Franziska investigator.; Wagner Michael investigator.; Weckbecker Klaus investigator.; Zimmermann Thomas investigator.
• Is Part Of: Journal of the American Geriatrics Society. Volume 65:Issue 4(2017:Apr.)
• Page Start: 738
• Page End: 746
• Publication Date: 2016-12-19
• Subjects: cognitive impairment -- mortality -- incidence -- survival -- dementia; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.14666
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract : Objectives: To investigate mortality risk and survival time in new‐incident cases of cognitive impairment (CI) in old age. Design: Prospective cohort study in six German cities. Setting: German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). Participants: Two thousand eighty‐nine nondemented GP patients aged 75+. Measurements: Every 18 months, trained psychologists and physicians conducted structured clinical interviews at the participants' homes. Dates of death were obtained from relatives, general practitioner (GP), or the local registry offices. We used the Kaplan–Meier survival method to estimate survival times of individuals with and without incident CI and multivariable Cox proportional hazards regressions to assess the association between CI and mortality risk, controlled for covariates. Results: Out of the 2, 089 included patients at follow‐up I, 859 (41.1%) died during the subsequent mean observation period of 8.0 years. Patients with incident CI at follow‐up I showed a significantly higher case‐fatality rate per 1, 000 person‐years (74.2, 95% CI = 64.2–84.2 vs 47.8, 95% CI = 44.6–51.0) and a significantly shorter mean survival time in the observation period than those without (7.8 vs 9.1 years; P < .001). The association between incident CI and mortality remained significant in the multivariable Cox analyses–incident CI was associated with a 42% increased, incident severe CI with a 75% increased mortality risk. Conclusion: Our findings suggest an elevated mortality risk in newly acquired cognitive deficits in old age. Even though further studies are required to analyze potential underlying mechanisms, our findings support the notion that such cognitive deficits should be taken seriously in clinical practice not only for an increased risk of developing dementia but also for a broader range of possible adverse health outcomes.