Faster cognitive decline in elders without dementia and decreased risk of cancer mortality: NEDICES Study.
OBJECTIVE
To assess whether faster cognitive decline in elders without dementia is associated with decreased risk of cancer mortality.


METHODS
In this population-based, prospective study of 2,627 people without dementia aged 65 years and older (Neurological Disorders in Central Spain), a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered at 2 visits (baseline and follow-up, approximately 3 years later). We divided change in 37-MMSE into tertiles (lower tertile ≥ 2 point improvement in score, higher tertile ≥ 2 point decline in score). Community-dwelling elders were followed for a median of 12.9 years, after which the death certificates of those who died were examined.


RESULTS
A total of 1,003 (38.2%) died, including 339 (33.8%) deaths among participants who were in the higher tertile of 37-MMSE change and 664 (66.2%) deaths among those in the remaining tertiles. Cancer was reported significantly less often in those in the higher tertile of MMSE change (20.6%) than in those in the remaining tertiles (28.6%): in an unadjusted Cox model, hazard ratio for cancer mortality in participants within the higher tertile = 0.75 (p = 0.04) compared with the participants within the remaining tertiles. In a Cox model that adjusted for a variety of demographic factors and comorbidities, hazard ratio for cancer mortality in participants within the higher tertile = 0.70 (p = 0.01).


CONCLUSIONS
In this population-based, prospective study of community-dwelling elders without dementia, faster cognitive decline was associated with a decreased risk of cancer mortality. Further studies are required to elucidate this inverse association in elders without dementia.
From the Department of Neurology (J.B.-L., J.P.R., F.B.-P.), University Hospital 12 de Octubre, Madrid; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (J.B.-L., F.B.-P.); Department of Medicine (J.B.-L., F.B.-P.), Complutense University, Madrid, Spain; G.H. Sergievsky Center (E.D.L.), Department of Neurology (E.D.L.), and Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.L.), College of Physicians and Surgeons, and Department of Epidemiology (E.D.L.), Mailman School of Public Health, Columbia University, New York.
Julián
J
Benito-León
Juan Pablo
JP
Romero
Elan D
ED
Louis
Félix
F
Bermejo-Pareja
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality*; D002423:Cause of Death; D060825:Cognitive Dysfunction / Q000401:mortality*; D003430:Cross-Sectional Studies; D020329:Essential Tremor / Q000401:mortality; D005260:Female; D006306:Health Surveys; D006801:Humans; D057187:Independent Living / Q000145:classification; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D009369:Neoplasms / Q000401:mortality*; D010300:Parkinson Disease / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011594:Psychometrics; D012306:Risk; D013030:Spain; D013223:Statistics as Topic; D020521:Stroke / Q000401:mortality