Abstract
Objective
To evaluate the potential independent and combined associations of cognitive and mobility
limitations on risk of all-cause mortality in a representative sample of the US older
adult population who, at baseline, were free of cardiovascular and cerebrovascular
disease.
Patients and Methods
Data from the 1999 to 2002 National Health and Nutrition Examination Survey were used
to identify 1852 adults (age, 60-85 years) with and without mobility and/or cognitive
limitations. Hazard ratios (HRs) for mortality risk were calculated for 4 mutually
exclusive groups: no limitation (group 1 as reference), mobility limitation only (group
2), cognitive limitation only (group 3), both cognitive and mobility limitations (group
4).
Results
Compared with group 1, the adjusted HRs (95% CI) for groups 2, 3, and 4 were 1.72
(1.24-2.38), 2.00 (1.37-2.91), and 2.18 (1.57-3.02), respectively. The mortality risk
when comparing group 4 (HR, 2.18) with group 3 (HR, 2.00), however, was not statistically
significant (P=.65). Similarly, the mortality risk when comparing group 4 (HR, 2.18) with group
2 (HR, 1.72) was not statistically significant (P=.16).
Conclusion
Although the highest mortality risk occurred in those with both limitations (group
4), this point estimate was not statistically significantly different when compared
with those with cognitive or mobility limitations alone.
Abbreviations and Acronyms:
DSST (Digit Symbol Substitution Test), HR (hazard ratio), MET (metabolic equivalent of task), NHANES (National Health and Nutrition Examination Survey)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Mayo Clinic ProceedingsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Trail making test predicts physical impairment and mortality in older persons.J Am Geriatr Soc. 2010; 58: 719-723
- Executive function correlates with walking speed in older persons: the InCHIANTI study.J Am Geriatr Soc. 2005; 53: 410-415
- Ageing, fitness and neurocognitive function.Nature. 1999; 400: 418-419
- Physical activity and executive functions in the elderly with mild cognitive impairment.Aging Ment Health. 2005; 9: 272-280
- Age differences in vigilance as a function of health-related physical fitness and task demands.Neuropsychologia. 2001; 39: 787-797
- Standard measures of executive function in predicting instrumental activities of daily living in older adults.Int J Geriatr Psychiatry. 2002; 17: 828-834
- Executive function and the frontal lobes: a meta-analytic review.Neuropsychol Rev. 2006; 16: 17-42
- Executive control functions in degenerative dementias: a comparative review.Neuropsychol Rev. 2000; 10: 75-99
- Quantitative cerebral anatomy of the aging human brain: a cross-sectional study using magnetic resonance imaging.Neurology. 1992; 42: 527-536
- Dementia, cognitive impairment and mortality in persons aged 65 and over living in the community: a systematic review of the literature.Int J Geriatr Psychiatry. 2001; 16: 751-761
- Incident subjective cognitive decline does not predict mortality in the elderly—results from the longitudinal German Study on Ageing, Cognition, and Dementia (AgeCoDe).PLoS One. 2016; 11: e0147050
- Effects of mobility and cognition on hospitalization and inpatient days in women in late life.J Gerontol A Biol Sci Med Sci. 2017; 72: 82-88
- Predictive validity of the American College of Cardiology/American Heart Association pooled cohort equations in predicting all-cause and cardiovascular disease-specific mortality in a National Prospective Cohort Study of Adults in the United States.Mayo Clin Proc. 2016; 91: 763-769
Edwards MK, Loprinzi PD. The fat-but-fit paradigm within the context of cognitive function [published online ahead of print March 28, 2017]. Am J Human Biol http://dx.doi.org/10.1002/ajhb.23001.
- Mental programming after frontal lobe lesions: results on digit symbol performance with self-selected goals.Cortex. 1991; 27: 203-211
- Deterioration of frontal lobe function in normal aging: influences of fluid intelligence versus perceptual speed.Neuropsychology. 1999; 13: 539-545
- Accelerometer-determined physical activity, mobility disability, and health.Disabil Health J. 2014; 7: 419-425
- The validity of self-reported nicotine product use in the 2001–2008 National Health and Nutrition Examination Survey.Med Care. 2010; 48: 1128-1132
- Dose-response association of moderate-to-vigorous physical activity with cardiovascular biomarkers and all-cause mortality: considerations by individual sports, exercise and recreational physical activities.Prev Med. 2015; 81: 73-77
- Compendium of physical activities: an update of activity codes and MET intensities.Med Sci Sports Exerc. 2000; 32: S498-S504
- Objectively measured physical activity and inflammatory markers among US adults with diabetes: implications for attenuating disease progression.Mayo Clin Proc. 2013; 88: 942-951
- Cause of death in mild cognitive impairment: a prospective study (NEDICES).Eur J Neurol. 2014; 21: 253-e259
- Walking speed at self-selected exercise pace is lower but energy cost higher in older versus younger women.J Phys Act Health. 2009; 6: 327-332
- Metabolic cost, mechanical work, and efficiency during walking in young and older men.Acta Physiol (Oxf). 2006; 186: 127-139
- Inflammation: the fire of frailty? Longevity and frailty.in: Research and Perspectives in Longevity. Vol XII. Springer, New York2005: 91-98
- Insulin-like growth factor I and interleukin-6 contribute synergistically to disability and mortality in older women.J Clin Endocrinol Metab. 2003; 88: 2019-2025
- The disablement process.Soc Sci Med. 1994; 38: 1-14
- Gait speed and survival in older adults.JAMA. 2011; 305: 50-58
- Mobility limitation in self-described well-functioning older adults: importance of endurance walk testing.J Gerontol A Biol Sci Med Sci. 2008; 63: 841-847
- Value of functional status as a predictor of mortality: results of a prospective study.Am J Med. 1992; 93 ([published corrections appear in Am J Med. 1993;94(5):560 and Am J Med. 1993;94(2):232]): 663-669
- Motoric cognitive risk syndrome: multicountry prevalence and dementia risk.Neurology. 2014; 83: 718-726
Article Info
Identification
Copyright
© 2017 Mayo Foundation for Medical Education and Research
