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J Gerontol A Biol Sci Med Sci. 2016 Jun;71(6):759-65. doi: 10.1093/gerona/glv220. Epub 2015 Dec 28.

Effects of Mobility and Cognition on Risk of Mortality in Women in Late Life: A Prospective Study.

Author information

1
Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis. Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota. ensru001@umn.edu.
2
California Pacific Medical Center Research Institute, San Francisco.
3
Division of Epidemiology & Community Health, University of Minnesota, Minneapolis.
4
Park Nicollet Clinic, St. Louis Park, Minnesota. Division of Health Policy & Management, University of Minnesota, Minneapolis.
5
Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minnesota.
6
Department of Epidemiology, University of Pittsburgh, Pennsylvania.
7
Department of Epidemiology and Biostatistics, University of California, San Francisco.
8
Department of Psychiatry, Department of Neurology and Department of Epidemiology, University of California, San Francisco.
9
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
10
Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis. Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.

Abstract

BACKGROUND:

This study examines the effects of mobility and cognition on mortality risk in women late in life.

METHODS:

A prospective study was conducted among 1,495 women (mean age 87.6 years) participating in the Study of Osteoporotic Fractures Year 20 examination (2006-2008). Mobility (ascertained by Short Physical Performance Battery [SPPB]) was categorized as poor (SPPB 0-3, n = 312), intermediate (SPPB 4-9, n = 799), or good (SPPB 10-12, n = 384). Cognitive status (adjudicated based on neuropsychological tests) was classified as normal (n = 873), mild cognitive impairment (n = 354), or dementia (n = 268). Deaths (n = 749) were identified from Year 20 through July 31, 2014 (average follow-up 4.9 years).

RESULTS:

There was not strong evidence of an interaction between mobility and cognition for prediction of mortality risk (p interaction term .16). Compared to women with good mobility, mortality risks were increased among women with intermediate mobility (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.02-1.57) and those with poor mobility (HR 1.64, 95% CI 1.24-2.16) after consideration of cognition and other mortality risk factors. Similarly, mortality risks were higher among women with mild cognitive impairment (HR 1.46, 95% CI 1.21-1.76) and those with dementia (HR 1.88, 95% CI 1.54-2.31) compared to women with normal cognition after consideration of mobility and other mortality risk factors.

CONCLUSIONS:

Among women late in life, 5-year mortality risk was substantially increased among women with deficits in mobility even after accounting for cognition and traditional prognostic indicators. Similarly, deficits in cognition were associated with increased 5-year mortality despite consideration of mobility and conventional risk factors.

KEYWORDS:

Cognitive status; Death; Elderly women; Physical function

PMID:
26714566
PMCID:
PMC4888393
DOI:
10.1093/gerona/glv220
[Indexed for MEDLINE]
Free PMC Article

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