title: Cognitive impairment, all-cause and cause-specific mortality among non-demented older adults.
abstract: BACKGROUND
  cognitive impairment is widespread among older adults even in the absence of dementia, but very little is known about the association between cognitive impairment not due or not yet converted to dementia and mortality. The association between cognitive impairment and mortality contributes to assessing cognitive impairment-related risk constellation in old age in the absence of manifest dementia.
  
  
  OBJECTIVE
  to assess the impact of cognitive impairment on all-cause and cause-specific mortality among non-demented older adults and to explore the nature of the association between cognitive impairment and mortality.
  
  
  METHODS
  an observational cohort study (ESTHER study; 2000-present).
  
  
  METHODS
  German state of Saarland.
  
  
  METHODS
  a subsample of 1,622 participants aged ≥70 with measurement of cognitive function through the Cognitive Telephone Screening Instrument (COGTEL) and exclusion of a possible dementia diagnosis at both COGTEL baseline (2005-08) and over the mortality follow-up (2005-13).
  
  
  RESULTS
  during an average follow-up of 6.1 years, 231 participants (14.2%) died. Participants with low COGTEL total scores had ∼60% increased mortality compared with participants with higher COGTEL total scores in Cox regression models adjusting for a wide range of possible confounders (hazard ratio = 1.62; confidence interval 1.13-2.33). Dose-response analyses with restricted cubic splines indicate a monotonic inverse relationship between cognitive function and mortality.
  
  
  CONCLUSIONS
  cognitive impairment in the absence of manifest dementia is an important independent predictor of mortality, especially among men. The administration of cognitive tests among older adults may provide relevant information for patient care and treatment decisions.
  
  
  BACKGROUND
  financial sponsors played no role in the design, execution, analysis and interpretation of data.
authors.affiliation: German Cancer Research Center (DKFZ) - Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581-69120 Heidelberg, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Perna
authors.affiliation: Department of Psychological Aging Research, Institute of Psychology, Heidelberg University, Hauptstrasse 47-51-69117 Heidelberg, Germany.
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Wahl
authors.affiliation: German Cancer Research Center (DKFZ) - Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581-69120 Heidelberg, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Mons
authors.affiliation: German Cancer Research Center (DKFZ) - Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581-69120 Heidelberg, Germany.
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Saum
authors.affiliation: Saarland Cancer Registry, Präsident Baltz Straβe 5-66119 Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: German Cancer Research Center (DKFZ) - Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 581-69120 Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D060825:Cognitive Dysfunction / Q000401:mortality*; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009026:Mortality; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors
keywords: cognition; cognitive impairment; mortality; older people