title: Executive function (capacity for behavioral self-regulation) and decline predicted mortality in a longitudinal study in Southern Colorado.
abstract: 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.
authors.affiliation: Department of Epidemiology, UT-MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: E
authors.initials: E
authors.lastname: Amirian
authors.forename: Judith
authors.initials: J
authors.lastname: Baxter
authors.forename: Jim
authors.initials: J
authors.lastname: Grigsby
authors.forename: Douglas
authors.initials: D
authors.lastname: Curran-Everett
authors.forename: John E
authors.initials: JE
authors.lastname: Hokanson
authors.forename: Lucinda L
authors.initials: LL
authors.lastname: Bryant
mesh_terms: 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