title: Impaired verbal memory is a significant predictor of early cerebral-cardiovascular death, an 18-year follow-up of a national cohort.
abstract: BACKGROUND
  The mortality pattern of individuals with impaired verbal memory (IVM) has not yet been well described. We sought to describe the risk of all-causes, as well as specific causes of death associated with IVM.
  
  
  METHODS
  We used the data of 4151 nationally representative adults ≥60 years old who participated in the third National Health and Nutrition Examination Survey, 1988-1994, and completed one non-contextual (i.e., word list memory) and one contextual delayed-recall tests (i.e., short story recall). The participants were passively followed up through 31 December 2006. We determined the hazard ratio of death from all-causes and specific cause through Cox proportional hazard regression.
  
  
  RESULTS
  Severe and moderate IVM were present in 268 (6.5%) and 495 (11.9%) participants at baseline survey, and 2550 deaths occurred by the end of 18-year follow-up (median = 12 years). The medians of survival time adjusted for all-causes death were 6.17 (95% CI: 5.50, 6.92), 9.50 (8.92, 10.25), and 13.17 (12.75, 13.58) years, respectively for the individuals with severe, moderate, and no IVM. Severe IVM was significantly associated with death from cardio-cerebral vascular diseases [hazard ratio = 1.70, 95% CI = (1.36-2.12)], stroke [2.60 (1.69-3.99)], and Alzheimer's disease [3.50 (1.40-8.76)]. The shortened survival time of the participants with IVM was mainly driven by the deaths of cerebral-cardiovascular diseases, which accounted for almost half of all deaths.
  
  
  CONCLUSIONS
  The predictability of memory scores to early cerebral-cardiovascular deaths demonstrated that central challenge among individuals with cognitive impairment was cardiovascular diseases management.
authors.affiliation: Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Lowry
authors.forename: Anissa
authors.initials: A
authors.lastname: Austin
authors.forename: Hasan
authors.initials: H
authors.lastname: Al-Sayegh
authors.forename: Fei
authors.initials: F
authors.lastname: Yan
authors.forename: Fengqi
authors.initials: F
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000150:complications / Q000401:mortality*; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000401:mortality*; D008875:Middle Aged; D009749:Nutrition Surveys; D011237:Predictive Value of Tests; D012307:Risk Factors; D012959:Socioeconomic Factors; D014706:Verbal Learning
keywords: cardiovascular disease; follow-up; memory; mortality