Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Abstract

BackgroundCognitive impairment may increase the risk of all‐cause and cardiovascular disease (CVD) mortality. This study examined the association between cognitive function and risk of all‐cause and CVD mortality among the elderly in Beijing, China.Methods and ResultsA total of 1996 participants aged ≥55 years at baseline were enrolled from the BLSA (Beijing Longitudinal Study of Aging). Cognitive function was assessed using the Mini‐Mental State Examination (MMSE), and participants were categorized as: <18, 18 to 23, 24 to 27, and 28 to 30. Cox proportional hazard models were used to estimate the association. Hazard ratio (HR) and 95% confidence interval (CI) were reported. During a 20‐year follow‐up, 1122 (56.21%) participants died, 478 (42.60%) of whom died of CVD. Compared with MMSE scores of 28 to 30, participants with MMSE scores of <18 were independently associated with all‐cause mortality (hazard ratio, 2.14; 95% confidence interval, 1.59–2.87; P<0.001) and CVD mortality (hazard ratio, 4.52; 95% confidence interval, 2.80–7.30, P<0.001). Each 5‐point decrease in MMSE score was associated with a 34% increased risk of all‐cause mortality and a 56% increased risk of CVD mortality. This relationship remained statistically significant after using the competing risk model to consider non‐CVD death as a competing risk event.ConclusionCognitive impairment measured by MMSE score was associated with elevated risk of all‐cause and CVD mortality among the elderly in Beijing, China.

Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

“…The previous study also found that the strength of this relationship differs due to the cause of death [19]. A strong link between CVD death and cognitive functions might be due to common cardiovascular risk factors [2,15].…”

“…Some studies did not find a significant difference between men and women in this association [13]. Another previous study ascertained that the risk was higher in the male group [15].…”

“…The mechanisms under this link are still unknown, but might include a decreased ability to follow the medical regime and self-care. It also might be the result of the lack of social integration [14,15]. Cognitive deficits in older age are often associated with vascular cognitive impairments.…”

Role of cognitive impairments and decreased muscle strength in cardiovascular mortality of 55 years and older population

“…Однако результаты этих исследований в отношении пожилого контингента носят зачастую противоречивый характер. Так, в исследовании Ji An, et al были показаны достоверные ассоциации между когнитивными нарушениями и смертностью от всех причин и ССЗ [21].…”

Prognostic significance of moderate cognitive impairment in patients at high and very high cardiovascular risk

“…An и соавт. [10] изучалась прогностическая роль КН, выявленных с помощью КШОПС, в отношении неблагоприятных кардиоваскулярных событий. Авторами был проведен анализ исследования BLSA (Beijing Longitudinal Study of Aging), включавшего 1996 участников, средний возраст которых составлял 69 лет.…”