Cognitive impairment as assessed by a short form of MMSE was predictive of mortality.
OBJECTIVE
This study explores the association between cognitive impairment and mortality in late senescence. A specific purpose was to validate the ability of a short form of the Mini-Mental State Examination (MMSE) in predicting mortality.


METHODS
The cognition-mortality link, as assessed by the original MMSE and D-MMSE (a subscale associated to dementia) was estimated on a community sample of 1,111 older people using Cox proportional hazards models.


RESULTS
Impaired cognitive function as assessed by both the original MMSE and D-MMSE predicted mortality in older men and women over long intervals. The association persisted after controlling for sociodemographic variables, Body Mass Index, mobility, and comorbidity and was unaffected by self-reported specific chronic diseases in both men and women. In addition, disease related risk of mortality was substantially reduced by sociodemographic and health variables including cognitive functioning. Only in women, stroke and diabetes remained statistically significant associated with mortality.


CONCLUSIONS
The association between cognitive impairment and mortality reflects processes different from those underlying a simple relation between chronic diseases and mortality. A short, valid MMSE subscale, which was a powerful predictor of mortality especially among men, is attractive for research and clinical practice.
Schultz-Larsen
Kirsten
K
Centre for Elder Research, Copenhagen University Hospital, Bispebjerg, Centre for Health and Society, Oster Sogade 18, 2nd floor, Copenhagen, DK 1357 K; Department of Social Medicine, Institute of Public Health, University of Copenhagen, Oster Farimagsgade 5, B, P.O. Box 2099, Copenhagen, DK 1014 K. Electronic address: ksl09@bbh.regionh.dk.
Rahmanfard
Naghmeh
N
Institute of Preventive Medicine, Centre for Health and Society, Copenhagen University Hospital, Oster Sogade 18, 1st floor, Copenhagen, DK-1357 K.
Kreiner
Svend
S
Department of Biostatistics, Institute of Public Health, University of Copenhagen, Oster Farimagsgade 5, B, P.O. Box 2099, Copenhagen, DK-1014 K.
Avlund
Kirsten
K
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Oster Farimagsgade 5, B, P.O. Box 2099, Copenhagen, DK 1014 K.
Holst
Claus
C
Institute of Preventive Medicine, Centre for Health and Society, Copenhagen University Hospital, Oster Sogade 18, 1st floor, Copenhagen, DK-1357 K.
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002908:Chronic Disease / Q000401:mortality; D003072:Cognition Disorders / Q000175:diagnosis* / Q000401:mortality; D003718:Denmark / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors