Impact of Combined Cognitive and Physical Impairments on Long-Term Prognosis in Elderly Cardiovascular Disease Patients: A Prospective Cohort Study.

Abstract

Purpose: This study aimed to evaluate the association between physical and cognitive function and long-term outcomes in elderly cardiovascular disease (CVD) patients, using the Short Physical Performance Battery (SPPB) and the Mini-Mental State Examination (MMSE).

Patients and methods: In this prospective cohort study, 524 patients aged ≥65 years hospitalized in the Department of Cardiology at Beijing Hospital from September 2018 to April 2019 were evaluated. Baseline demographic, clinical, laboratory, and functional data were collected, and physical and cognitive function were assessed using SPPB and MMSE scores. Patients were followed for all-cause mortality over a 5-year period. Kaplan-Meier survival analysis and Cox proportional hazards models were used to examine the mortality risk associated with impairments.

Results: Physical impairment was identified in 28.2% and cognitive impairment in 12.4% of patients. The combination of both impairments was associated with a 5.47-fold increased mortality risk (HR: 5.47; 95% CI: 2.78-10.78; p<0.001). Each 1-point increase in SPPB and MMSE scores correlated with a 16.3% and 8.7% reduction in mortality risk, respectively. Cognitive function, particularly attention and calculation ability, has emerged as a significant predictor of survival.

Conclusion: Combined physical and cognitive impairments are prevalent in elderly CVD patients and strongly predict poor long-term prognosis. Routine assessment of cognitive function alongside physical performance can improve clinical decision-making, intervention strategies, and patient management, offering the potential to enhance outcomes in this high-risk population.