Exploring the association between cognitive decline and all-cause mortality with blood pressure as a potential modifier in oldest old individuals.

Journal: Scientific reports

Volume: 12

Issue: 1

Year of Publication: 2022

Affiliated Institutions:  Department of Medical Record Statistics, Peking University Shenzhen Hospital, No. , Lianhua Road, Futian District, Shenzhen, , China. Department of Medical Research and Innovation, School of Medicine, University for Development Studies, Tamale, N/R, Ghana. Department of Cardiovascular Medicine, Peking University Shenzhen Hospital, Shenzhen, China. Department of Medical Record Statistics, Peking University Shenzhen Hospital, No. , Lianhua Road, Futian District, Shenzhen, , China. liuyansz@.com.

Abstract summary 

Few studies have systematically explored the association between cognitive decline and all-cause mortality among oldest old individuals (above 80 years old), and there is limited evidence of blood pressure (BP) as a potential effect modifier. Therefore, this study included 14,891 oldest old individuals (mean age: 90.3 ± 7.5 years); 10,904 deaths and 34,486 person-years were observed. Cognitive scores were calculated using the Chinese version of the Mini-Mental State Examination (MMSE). Cognitive decline was stratified into ten categories (C0-C9). Continuous cognitive scores were used to assess the interactions of modifiers of the cognitive decline and all-cause mortality association and potentially modifiable factors. Potential effect modifiers were explored by age, sex, BP status and hypertension. Cox proportional hazards models were used to evaluate the relationship between cognitive decline and all-cause mortality after adjustments for demographic characteristics, socioeconomic status, lifestyle factors, leisure activities and health conditions. Participants who progressed to severe cognitive impairment from high normal cognitive function (C3), low normal cognitive function (C6), or mild cognitive impairment (C8) had 55%, 56%, and 63% higher mortality risks, respectively, than those who maintained high normal cognitive function (C0). The multivariate-adjusted model indicated that oldest old individuals with a decrease of more than one point in the MMSE score per year had an approximately 4% all-cause mortality risk. The relationship between cognitive decline and mortality was statistically influenced by sex (P = 0.013), high BP in nonagenarians (P = 0.003), and hypertension (P = 0.004) but not by age (P = 0.277). Our findings suggest that periodic screening for cognitive decline and strengthening BP management may be necessary for public health.

Authors & Co-authors:  Duan Jun J Sam Napoleon Bellua NB Wang Shi-Jia SJ Liu Yan Y

Study Outcome 

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Statistics
Citations :  Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, Yu Y, Kou C, Xu X, Lu J, et al. Prevalence of mental disorders in China: A cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–224. doi: 10.1016/S2215-0366(18)30511-X.
Authors :  4
Identifiers
Doi : 17108
SSN : 2045-2322
Study Population
Male,Female
Mesh Terms
Aged, 80 and over
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England