title: Decline in cognitive function and risk of elder self-neglect: finding from the Chicago Health Aging Project.
abstract: OBJECTIVE
  To examine the longitudinal association between decline in cognitive function and risk of elder self-neglect in a community-dwelling population.
  
  
  METHODS
  Prospective population-based study.
  
  
  METHODS
  Geographically defined community in Chicago.
  
  
  METHODS
  Community-dwelling subjects reported to the social services agency from 1993 to 2005 for self-neglect who also participated in the Chicago Health Aging Project (CHAP). Of the 5,519 participants in CHAP, 1,017 were reported to social services agency for suspected elder self-neglect from 1993 to 2005.
  
  
  METHODS
  Social services agency identified reported elder self-neglect. The primary predictor was decline in cognitive function assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Executive Function), and immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z-scores of all tests. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these longitudinal associations.
  
  
  RESULTS
  After adjusting for potential confounding factors, decline in global cognitive function, MMSE score, and episodic memory were not independently associated with greater risk of reported and confirmed elder self-neglect. Decline in executive function was associated with greater risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with greater risk of greater self-neglect severity (parameter estimate=0.76, standard error=0.31, P=.01).
  
  
  CONCLUSIONS
  Decline in executive function was associated with risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with risk of greater self-neglect severity.
authors.affiliation: Rush University Medical Center, Chicago, Illinois, USA. xinqi_dong@rush.edu
authors.forename: XinQi
authors.initials: X
authors.lastname: Dong
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Simon
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Mendes de Leon
authors.forename: K Bharat
authors.initials: KB
authors.lastname: Rajan
authors.forename: Denis A
authors.initials: DA
authors.lastname: Evans
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002641:Chicago / Q000453:epidemiology; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D015340:Epidemiologic Research Design; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D008568:Memory; D051346:Mobility Limitation; D009043:Motor Activity; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014145:Trail Making Test; D014888:Wechsler Scales / Q000706:statistics & numerical data