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Five-year mortality in relation to dementia and cognitive function in 95-year-olds
Anne Börjesson-Hanson1, Deborah Gustafson, Ingmar Skoog
1Neuropsychiatric Epidemiology Unit, Psychiatry Section, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Göteborg University, Sweden. anne.borjesson@neuro.gu.se
Neurology
|November 28, 2007
Summary
Dementia significantly increases mortality risk in 95-year-olds, acting as the leading cause of death. Cognitive performance also predicts survival in those without dementia, highlighting the importance of brain health in extreme longevity.
Area of Science:
- Gerontology and Epidemiology
- Neuroscience and Aging Research
Background:
- Dementia is a known predictor of mortality, but its impact on individuals over 90 remains uncertain due to limited research.
- Studies often lack sufficient participants in advanced age groups, necessitating further investigation into dementia's role in mortality for the oldest old.
Purpose of the Study:
- To investigate the 5-year mortality rates in individuals aged 95 and above in relation to dementia diagnosis and cognitive function.
- To determine the predictive value of dementia and cognitive performance on mortality in the oldest-old population.
Main Methods:
- A population-based cohort of 338 individuals aged 95 was followed for five years until age 100.
- Dementia was diagnosed using DSM-III-R criteria, and cognitive function was assessed with the Mini-Mental State Examination (MMSE).
- Mortality data and severe physical disorders were obtained from Swedish national registers.
Main Results:
- Five-year mortality was significantly higher for 95-year-olds with dementia (96%) compared to those without (73%), even after adjusting for physical disorders.
- Cox regression analysis identified dementia as a major predictor of mortality (Population Attributable Risk [PAR] 42%), alongside cardiac disease (PAR 17%), cancer (PAR 6%), and male sex (PAR 7%).
- Among individuals without dementia, higher MMSE scores predicted lower mortality, with each point increase associated with a 13% decrease in mortality risk.
Conclusions:
- Dementia and cognitive performance are significant factors influencing mortality in 95-year-olds.
- Dementia emerged as the leading cause of death in the oldest-old population, even when controlling for other severe medical conditions.
- Further research is needed to fully understand the mechanisms by which dementia and cognitive function impact life expectancy in extreme old age.
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