Executive function and mortality in homebound elderly adults.
OBJECTIVE
To determine the association between executive function and mortality in homebound elderly adults.


METHODS
Longitudinal study.


METHODS
Four home care agencies in the Boston area.


METHODS
Homebound adults aged 60 and older with 8-year follow-up for mortality (N=1,172).


METHODS
Cognitive domains including executive, memory, and language functions were evaluated at baseline. Executive function was measured using the Trail-Making Test Part B (TMT B), and subjects were divided into four subgroups from lowest to highest TMT B score. The second cross-group analyses were used to compare those who were alive and those who had died. Multivariate logistic regression analysis was used to determine whether there was an association between TMT B scores and mortality.


RESULTS
At baseline, 436 (37.2%) homebound elderly adults had the highest TMT B scores (≥300), which indicated the slowest performance. At 8-year follow-up, 381 (32.5%) participants had died. Participants with the highest TMT B scores were more than twice as likely to have died as those with the lowest scores (0–99) (odds ratio=2.39, 95% confidence interval=1.27–4.52, P=.003) after adjusting for confounders including medical comorbidities related to death. The other cognitive domains, including memory and language, were not associated with mortality in the same model.


CONCLUSIONS
Many homebound elderly adults have multiple medical conditions, and executive function may be critical in their ability to manage their medical conditions and may affect the outcome of death.
Department of Pharmacology, Experimental Therapeutics, Boston University Medical Campus, Boston, Massachusetts.
Linh N
LN
Vu
Department of Pharmacology, Experimental Therapeutics, Boston University Medical Campus, Boston, Massachusetts.
Michael J
MJ
Dean
Department of Public Health and Family Medicine, School of Medicine, Tufts University, Boston, Massachusetts.
Mkaya
M
Mwamburi
Department of Neurology, Boston University Medical Campus, Boston, Massachusetts.
Rhoda
R
Au
Department of Pharmacology, Experimental Therapeutics, Boston University Medical Campus, Boston, Massachusetts.|Department of Psychiatry, Boston University Medical Campus, Boston, Massachusetts.|Alzheimer's Disease Center, Boston University Medical Campus, Boston, Massachusetts.
Wei Qiao
WQ
Qiu
D000368:Aged; D000369:Aged, 80 and over; D001900:Boston / Q000453:epidemiology; D056344:Executive Function; D005260:Female; D018577:Homebound Persons / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009483:Neuropsychological Tests