Executive function (capacity for behavioral self-regulation) and decline predicted mortality in a longitudinal study in Southern Colorado.
OBJECTIVE
To assess the relationship between mortality and impairment and decline in a specific executive cognitive function, the capacity for behavioral self-regulation.


METHODS
This study examined the association between mortality and baseline and 22-month decline in the capacity for behavioral self-regulation, as measured by the Behavioral Dyscontrol Scale, among 1,293 participants of the San Luis Valley Health and Aging Study (SLVHAS), a population-based longitudinal study. The Behavioral Dyscontrol Scale and a measure of overall mental status, the Mini-Mental State Examination, were administered at baseline and follow-up interviews. Cox regression was used to examine baseline and decline in capacity for behavioral self-regulation as possible predictors of mortality.


RESULTS
Baseline Behavioral Dyscontrol Scale score was predictive of mortality, independent of demographics and comorbidity count (hazard ratio [HR]=1.07; 95% confidence interval [CI]: 1.04, 1.09). It remained a significant predictor with further adjustment for Mini-Mental State Examination score. Decline in this specific executive cognitive function was associated with mortality after adjustment for covariates and baseline cognitive scores (HR=1.09; 95% CI: 1.04, 1.13).


CONCLUSIONS
Thus, both baseline capacity for behavioral self-regulation and its decline over time predicted mortality in the SLVHAS cohort. These associations may partly be attributed to maintaining the ability for self-care. Understanding how specific forms of impairment contribute to mortality may help identify patients who could benefit from early intervention.
Amirian
E
E
Department of Epidemiology, UT-MD Anderson Cancer Center, Houston, TX, USA.
Baxter
Judith
J
Grigsby
Jim
J
Curran-Everett
Douglas
D
Hokanson
John E
JE
Bryant
Lucinda L
LL
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000401:mortality* / Q000523:psychology; D003120:Colorado / Q000453:epidemiology; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012927:Social Control, Informal