Associations of cognitive impairment and functional limitation with all-cause mortality risk in older adults: A population-based study from the National Health and Nutrition Examination Survey.

IF 1.4 4区 心理学 Q4 CLINICAL NEUROLOGY
Wenxiu Zhu, Xuyan Zhao, Qingqin Xu, Yun Xue
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Abstract

Cognitive impairment and functional limitation are commonly observed in older adults. They have a complex correlation, and both are risk factors for mortality. This prospective cohort study aimed to explore the independent and joint impact of cognitive impairment and functional limitations on all-cause mortality in older adults. A total of 3,759 participants aged ≥ 60 years who had available information on mortality data, cognitive function, physical function, and covariates were enrolled. Cox proportional hazards regression models were employed to assess the independent and joint impacts of cognitive impairment and functional limitation on all-cause mortality. Smoothing curve fitting was used to show the nonlinear relationship between the Digit Symbol Coding (DSC) score and all-cause mortality. An interaction between cognitive impairment and functional limitation was identified when examining their associations with all-cause mortality. Cognitive impairment and functional limitation independently correlated with all-cause mortality risk even after adjusting for covariates and performing mutual adjustments (HR for cognitive impairment: 1.34, 95% CI 1.15-1.56; HR for functional limitation: 1.50, 95% CI 1.32-1.70). When the DSC score was > 18, as the score increased, the risk of death significantly decreased (HR 0.99, 95% CI 0.98-0.99). Participants with both cognitive impairment and functional limitation had the highest hazard ratio for all-cause mortality (HR 1.98, 95%CI 1.63-2.40). In summary, cognitive impairment and functional limitation independently correlated with increased all-cause mortality risk. A higher DSC score was a protective factor reducing the premature mortality risk. Older adults with cognitive impairment and functional limitation demonstrated the highest all-cause mortality risk.

认知障碍和功能限制与老年人全因死亡风险的关系:一项基于全国健康与营养调查的人口研究。
认知障碍和功能限制是老年人常见的症状。它们之间有着复杂的相关性,并且都是导致死亡的风险因素。这项前瞻性队列研究旨在探讨认知障碍和功能限制对老年人全因死亡率的独立和共同影响。研究共纳入了 3759 名年龄≥ 60 岁的参与者,他们都有关于死亡率数据、认知功能、身体功能和协变量的可用信息。采用 Cox 比例危险回归模型来评估认知功能障碍和功能限制对全因死亡率的独立和联合影响。平滑曲线拟合用于显示数字符号编码(DSC)得分与全因死亡率之间的非线性关系。在研究认知障碍和功能限制与全因死亡率的关系时,发现了认知障碍和功能限制之间的交互作用。即使在调整了协变量并进行了相互调整后,认知障碍和功能限制仍与全因死亡风险独立相关(认知障碍的 HR:1.34,95% CI:1.34,95% CI:1.34):认知障碍的 HR 为 1.34,95% CI 为 1.15-1.56;功能限制的 HR 为 1.50,95% CI 为 1.56:1.50,95% CI 1.32-1.70)。当 DSC 评分大于 18 分时,随着评分的增加,死亡风险显著降低(HR 0.99,95% CI 0.98-0.99)。同时患有认知障碍和功能障碍的参与者全因死亡的危险比最高(HR 1.98,95%CI 1.63-2.40)。总之,认知障碍和功能受限与全因死亡风险的增加存在独立相关性。较高的 DSC 评分是降低过早死亡风险的保护因素。有认知障碍和功能障碍的老年人全因死亡风险最高。
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来源期刊
Applied Neuropsychology-Adult
Applied Neuropsychology-Adult CLINICAL NEUROLOGY-PSYCHOLOGY
CiteScore
4.50
自引率
11.80%
发文量
134
期刊介绍: pplied Neuropsychology-Adult publishes clinical neuropsychological articles concerning assessment, brain functioning and neuroimaging, neuropsychological treatment, and rehabilitation in adults. Full-length articles and brief communications are included. Case studies of adult patients carefully assessing the nature, course, or treatment of clinical neuropsychological dysfunctions in the context of scientific literature, are suitable. Review manuscripts addressing critical issues are encouraged. Preference is given to papers of clinical relevance to others in the field. All submitted manuscripts are subject to initial appraisal by the Editor-in-Chief, and, if found suitable for further considerations are peer reviewed by independent, anonymous expert referees. All peer review is single-blind and submission is online via ScholarOne Manuscripts.
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