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Mortality rates and predictors in community-dwelling elderly individuals with cognitive impairment: an eight-year follow-up after initial assessment.
- Source :
-
International psychogeriatrics [Int Psychogeriatr] 2014 Aug; Vol. 26 (8), pp. 1295-304. - Publication Year :
- 2014
-
Abstract
- Background: We assessed eight-year mortality rates and predictors in a rural cohort of elderly individuals with cognitive impairment.<br />Methods: A total of 1,035 individuals, including 155 (15.0%) individuals with cognitive impairment, no dementia (CIND), and 69 (6.7%) individuals with clinically diagnosed dementia were followed for eight years from 1997. The initial assessment involved a two-step diagnostic procedure performed during a door-to-door survey, and mortality data were obtained from the Korean National Statistical Office (KNSO). The relationship between clinical diagnosis and risk of death was examined using the Cox proportional hazards model after adjusting for age, sex, and education.<br />Results: During follow-up, 392 individuals died (37.9%). Compared to persons without cognitive impairment, mortality risk was nearly double among those with CIND (hazard ratio [95% confidence interval], 1.92 [1.46-2.54]), and this increased more than three-fold among those with dementia (3.20 [2.30-4.44]). Old age and high scores on the behavioral changes scale at diagnosis were two common predictors of mortality among those with CIND and dementia. Among the items on the behavioral changes scale, low sociability, less spontaneity, and poor hygiene were associated with increased mortality in individuals with CIND. Conversely, low sociability, excessive emotionality, and irritability were associated with increased mortality in patients with dementia.<br />Conclusions: Both dementia and CIND increased mortality risk compared with normal cognition in this community cohort. It is important to identify and manage early behavioral changes to reduce mortality in individuals with CIND and dementia.
- Subjects :
- Age Factors
Aged
Disease Progression
Female
Follow-Up Studies
Geriatric Assessment methods
Humans
Independent Living psychology
Independent Living statistics & numerical data
Male
Middle Aged
Proportional Hazards Models
Republic of Korea epidemiology
Risk Assessment
Rural Population statistics & numerical data
Socioeconomic Factors
Survival Analysis
Behavioral Symptoms diagnosis
Behavioral Symptoms epidemiology
Behavioral Symptoms etiology
Behavioral Symptoms psychology
Cognition Disorders complications
Cognition Disorders diagnosis
Cognition Disorders mortality
Cognition Disorders psychology
Dementia diagnosis
Dementia etiology
Dementia mortality
Dementia psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1741-203X
- Volume :
- 26
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- International psychogeriatrics
- Publication Type :
- Academic Journal
- Accession number :
- 24965360
- Full Text :
- https://doi.org/10.1017/S1041610214000556