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Individual and Combined Associations of Cognitive and Mobility Limitations on Mortality Risk in Older Adults

  • Emily Frith
    Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, Jackson
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  • Ovuokerie Addoh
    Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, Jackson
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  • Joshua R. Mann
    Department of Preventive Medicine, University of Mississippi Medical Center, Jackson
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  • B. Gwen Windham
    Department of Medicine, Division of Geriatrics, Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson
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  • Paul D. Loprinzi
    Correspondence: Address to Paul D. Loprinzi, PhD, Jackson Heart Study Vanguard Center of Oxford, Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, School of Applied Sciences, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, 229 Turner Center, University, MS 38677.
    Jackson Heart Study Vanguard Center of Oxford, Jackson; and the Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University
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      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).


      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).


      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)
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