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Updated: Jul 5, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Cognitive impairment as assessed by a short form of MMSE was predictive of mortality
Kirsten Schultz-Larsen1, Naghmeh Rahmanfard2, Svend Kreiner3
1Centre for Elder Research, Copenhagen University Hospital, Bispebjerg, Centre for Health and Society, Oster Sogade 18, 2nd floor, Copenhagen, DK 1357 K; Department of Social Medicine, Institute of Public Health, University of Copenhagen, Oster Farimagsgade 5, B, P.O. Box 2099, Copenhagen, DK 1014 K.
Objective:
This study explores the association between cognitive impairment and mortality in late senescence. A specific purpose was to validate the ability of a short form of the Mini-Mental State Examination (MMSE) in predicting mortality.
Study Design And Setting:
The cognition-mortality link, as assessed by the original MMSE and D-MMSE (a subscale associated to dementia) was estimated on a community sample of 1,111 older people using Cox proportional hazards models.
Results:
Impaired cognitive function as assessed by both the original MMSE and D-MMSE predicted mortality in older men and women over long intervals. The association persisted after controlling for sociodemographic variables, Body Mass Index, mobility, and comorbidity and was unaffected by self-reported specific chronic diseases in both men and women. In addition, disease related risk of mortality was substantially reduced by sociodemographic and health variables including cognitive functioning. Only in women, stroke and diabetes remained statistically significant associated with mortality.
Conclusion:
The association between cognitive impairment and mortality reflects processes different from those underlying a simple relation between chronic diseases and mortality. A short, valid MMSE subscale, which was a powerful predictor of mortality especially among men, is attractive for research and clinical practice.
Insights
Cognitive impairment, measured by the Mini-Mental State Examination (MMSE), predicts mortality in older adults. A short MMSE form effectively identifies this risk, aiding clinical practice and research.
Area of Science:
- Gerontology
- Cognitive Neuroscience
- Epidemiology
Background:
- Cognitive impairment is a growing concern in aging populations.
- Understanding factors predicting mortality in late senescence is crucial for public health.
- The Mini-Mental State Examination (MMSE) is a widely used cognitive assessment tool.
Purpose of the Study:
- To investigate the association between cognitive impairment and mortality in older adults.
- To validate a short form of the MMSE (D-MMSE) in predicting mortality.
- To differentiate the cognitive impairment-mortality link from chronic disease-related mortality.
Main Methods:
- A community-based cohort of 1,111 older individuals was studied.
- Cox proportional hazards models were used to analyze the cognition-mortality link.
- Both the original MMSE and the D-MMSE were employed for cognitive assessment.
Main Results:
- Impaired cognitive function, assessed by MMSE and D-MMSE, significantly predicted mortality in both men and women.
- This association remained robust after adjusting for sociodemographic factors, BMI, mobility, and comorbidities.
- Cognitive functioning substantially mediated the mortality risk associated with chronic diseases, particularly in women (stroke, diabetes).
Conclusions:
- The link between cognitive impairment and mortality involves distinct mechanisms compared to chronic disease-related mortality.
- A short, validated MMSE subscale (D-MMSE) is a powerful predictor of mortality, especially in men.
- The D-MMSE shows promise for both research and clinical application in assessing mortality risk in older adults.
