Associations Between Cognitive Functioning and Mortality in a Population-Based Sample of Older United States Adults: Differences by Sex and Education

Author:

Adjoian Mezzaca Tamar1ORCID,Dodds Leah V.2,Rundek Tatjana3,Zeki Al Hazzouri Adina4,Caunca Michelle R.2,Gomes-Osman Joyce35,Loewenstein David A.6,Schneiderman Neil7,Elfassy Tali8ORCID

Affiliation:

1. Independent Consultant, New York, NY, USA

2. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

3. Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA

4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY, USA

5. Department of Physical Therapy, Miami Miller School of Medicine, Miami, FL, USA

6. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

7. Department of Psychology, University of Miami, Coral Gables, FL, USA

8. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

Abstract

Objective: To determine whether cognition is associated with mortality among older US adults. Methods: We studied 5,989 National Health and Nutrition Examination Survey participants age 60+ in years 1999–2014 with mortality follow-up through 2015. Cognitive function was measured in one standard deviation decrements using the Digit Symbol Substitution Test (DSST), Animal Fluency (AnFl), and two Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) tests. Results: Each decrement in cognitive function was associated with increased risk of mortality overall (DSST HR: 1.36, 95% CI: 1.25, 1.48), among women only (AnFl: 1.51, 95% CI: 1.02, 2.24), and among those with less than a high school education only (AnFl HR: 1.46, 95% CI: 1.09, 1.97; CERAD-WL HR: 1.34, 95% CI: 1.07, 1.67; and CERAD-DR HR: 1.38, 95% CI: 1.05, 1.82). Discussion: Among US adults, lower cognitive functioning was associated with mortality; associations were stronger among women and those with less education.

Funder

National Institute on Minority Health and Health Disparities

National Institute on Aging

Publisher

SAGE Publications

Subject

Geriatrics and Gerontology,Community and Home Care,Gerontology

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