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Predictors of mortality in home-dwelling patients with cardiovascular disease aged 75 and older

Timo E Strandberg1, Kaisu H Pitkala, Reijo S Tilvis

  • 1Department of Health Sciences/Geriatrics, University of Oulu, Oulu University Hospital, Finland. timo.strandberg@oulu.fi

Journal of the American Geriatrics Society
|February 12, 2009
PubMed

Insights

Cognitive impairment, measured by Mini Mental State Examination (MMSE), strongly predicts mortality in older cardiovascular disease (CVD) patients. This cognitive indicator proved more significant than traditional biomarkers for predicting 6-year mortality.

Area of Science:

  • Gerontology
  • Cardiology
  • Neurology

Background:

  • Cardiovascular disease (CVD) is prevalent in older adults.
  • Cognitive function is increasingly recognized as a factor in overall health outcomes.
  • Predicting mortality in elderly CVD patients requires understanding various health indicators.

Purpose of the Study:

  • To compare the predictive value of common biomarkers in older CVD patients with cognitive function.
  • To identify the strongest predictor of mortality in this population.

Main Methods:

  • Prospective cohort study of 398 home-dwelling older adults with stable CVD.
  • Cognitive function assessed using the Mini Mental State Examination (MMSE).
  • Mortality prediction using clinical and laboratory measurements over a 6-year follow-up.

Main Results:

  • Low MMSE score (indicating cognitive impairment) was the strongest predictor of mortality (relative hazard 2.38).
  • Creatinine, C-reactive protein, and history of congestive heart failure were also significant predictors.
  • Conventional CVD risk factors were not significant independent predictors of mortality.

Conclusions:

  • Impaired cognitive function, assessed by MMSE, is a powerful independent predictor of 6-year mortality in older adults with CVD.
  • Few clinical variables independently predicted mortality, highlighting the importance of cognitive assessment.
Abstract

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