Cognitive Function in Dementia-Free Subjects and Survival in Old Age: The PROSPER Study - 12/12/19
Abstract |
Background |
Impairment in domain-specific cognitive function is associated with the increased risk of mortality. We prospectively evaluated the association of executive function and memory with the risk of long-term mortality in dementia-free older subjects. Moreover, we investigated the role of structural brain abnormalities in this association.
Methods |
We included 547 dementia-free participants (mean age 78 years, 56.5% male) from the nested magnetic resonance imaging sub-study of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). Cox proportional hazard models were used to model 10-year risk of all-cause, cardiovascular, and noncardiovascular mortality in relation to performance in executive function and memory. Moreover, we evaluated the role of total brain parenchymal volume, cerebral blood flow, white matter hyperintensity, and the presence of microbleeds and infarcts in the link between cognitive function and mortality.
Results |
In the multivariable model, lower performance in executive function was associated with greater risk of all-cause (hazard ratio [HR] 1.49; 95% confidence interval [CI], 1.31-1.70), cardiovascular (HR 1.69; 95% CI, 1.36-2.11), and noncardiovascular (HR 1.36; 95% CI, 1.15-1.62) mortality. Similarly, poorer performance in memory tests associated with higher risk of all-cause (HR 1.47; 95% CI, 1.29-1.68), cardiovascular (HR 1.45; 95% CI, 1.15-1.83), and noncardiovascular (HR 1.49; 95% CI, 1.27-1.76) mortality. The associations were similar in subjects with various levels of brain structural abnormalities and cerebral blood flow (all P for interaction ≫ .05).
Conclusions |
Poorer performance in both executive function and memory tests associates with all-cause, cardiovascular, and noncardiovascular mortality in elderly individuals. This association is independent of cardiovascular risk factors and diseases, brain structural abnormalities, and cerebral blood flow.
El texto completo de este artículo está disponible en PDF.Keywords : Executive function, Memory, Mortality, Older subjects, Structural brain abnormalities
Esquema
| Funding: The original PROSPER clinical trial was founded by a grant from Bristol-Myers Squibb. The company had no involvement in the formulation of hypotheses, analysis of the data, or in any aspects of the preparation of this manuscript. |
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| Conflict of Interest: None. |
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| Authorship: All authors had access to the data and a role in writing this manuscript. SR, SH, and BS designed and conceptualized the study. SR and SH analyzed the data. SR drafted the manuscript for intellectual content. SR, SH, JG, MAB, IF, JWJ, and BS interpreted the data and critically revised the manuscript for intellectual content. All authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Any data not published in this article are available at Leiden University Medical Centre. The datasets used and analyzed regarding the present study will be shared on request from any qualified investigator for reasonable purposes. |
Vol 132 - N° 12
P. 1466 - décembre 2019 Regresar al número
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