title: Mortality rates and predictors in community-dwelling elderly individuals with cognitive impairment: an eight-year follow-up after initial assessment.
abstract: BACKGROUND
  We assessed eight-year mortality rates and predictors in a rural cohort of elderly individuals with cognitive impairment.
  
  
  METHODS
  A total of 1,035 individuals, including 155 (15.0%) individuals with cognitive impairment, no dementia (CIND), and 69 (6.7%) individuals with clinically diagnosed dementia were followed for eight years from 1997. The initial assessment involved a two-step diagnostic procedure performed during a door-to-door survey, and mortality data were obtained from the Korean National Statistical Office (KNSO). The relationship between clinical diagnosis and risk of death was examined using the Cox proportional hazards model after adjusting for age, sex, and education.
  
  
  RESULTS
  During follow-up, 392 individuals died (37.9%). Compared to persons without cognitive impairment, mortality risk was nearly double among those with CIND (hazard ratio [95% confidence interval], 1.92 [1.46-2.54]), and this increased more than three-fold among those with dementia (3.20 [2.30-4.44]). Old age and high scores on the behavioral changes scale at diagnosis were two common predictors of mortality among those with CIND and dementia. Among the items on the behavioral changes scale, low sociability, less spontaneity, and poor hygiene were associated with increased mortality in individuals with CIND. Conversely, low sociability, excessive emotionality, and irritability were associated with increased mortality in patients with dementia.
  
  
  CONCLUSIONS
  Both dementia and CIND increased mortality risk compared with normal cognition in this community cohort. It is important to identify and manage early behavioral changes to reduce mortality in individuals with CIND and dementia.
authors: Department of Psychiatry and Behavioral Science,Seoul National University College of Medicine,Seoul,South Korea.
authors: Jee Eun
authors: JE
authors: Park
authors: Department of Psychiatry and Behavioral Science,Seoul National University College of Medicine,Seoul,South Korea.
authors: Jun-Young
authors: JY
authors: Lee
authors: Department of Psychiatry,Dongtan Sacred Heart Hospital,Hallym University College of Medicine,Seoul,South Korea.
authors: Guk-Hee
authors: GH
authors: Suh
authors: Department of Psychiatry,Kyungpook National University Medical Center,Kyungpook National University School of Medicine,Daegu,South Korea.
authors: Byung-Soo
authors: BS
authors: Kim
authors: Department of Psychiatry and Behavioral Science,Seoul National University College of Medicine,Seoul,South Korea.
authors: Maeng Je
authors: MJ
authors: Cho
mesh_terms: D000367:Age Factors; D000368:Aged; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D057187:Independent Living / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016019:Survival Analysis