title: Effects of Mobility and Cognition on Risk of Mortality in Women in Late Life: A Prospective Study.
abstract: This study examines the effects of mobility and cognition on mortality risk in women late in life.
  
  
  
  A prospective study was conducted among 1,495 women (mean age 87.6 years) participating in the Study of Osteoporotic Fractures Year 20 examination (2006-2008). Mobility (ascertained by Short Physical Performance Battery [SPPB]) was categorized as poor (SPPB 0-3, n = 312), intermediate (SPPB 4-9, n = 799), or good (SPPB 10-12, n = 384). Cognitive status (adjudicated based on neuropsychological tests) was classified as normal (n = 873), mild cognitive impairment (n = 354), or dementia (n = 268). Deaths (n = 749) were identified from Year 20 through July 31, 2014 (average follow-up 4.9 years).
  
  
  
  There was not strong evidence of an interaction between mobility and cognition for prediction of mortality risk (p interaction term .16). Compared to women with good mobility, mortality risks were increased among women with intermediate mobility (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.02-1.57) and those with poor mobility (HR 1.64, 95% CI 1.24-2.16) after consideration of cognition and other mortality risk factors. Similarly, mortality risks were higher among women with mild cognitive impairment (HR 1.46, 95% CI 1.21-1.76) and those with dementia (HR 1.88, 95% CI 1.54-2.31) compared to women with normal cognition after consideration of mobility and other mortality risk factors.
  
  
  
  Among women late in life, 5-year mortality risk was substantially increased among women with deficits in mobility even after accounting for cognition and traditional prognostic indicators. Similarly, deficits in cognition were associated with increased 5-year mortality despite consideration of mobility and conventional risk factors.
authors.affiliation: Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis. Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota. ensru001@umn.edu.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco.
authors.forename: Li-Yung
authors.initials: LY
authors.lastname: Lui
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis.
authors.forename: Misti L
authors.initials: ML
authors.lastname: Paudel
authors.affiliation: Park Nicollet Clinic, St. Louis Park, Minnesota. Division of Health Policy & Management, University of Minnesota, Minneapolis.
authors.forename: John T
authors.initials: JT
authors.lastname: Schousboe
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minnesota.
authors.forename: Allyson M
authors.initials: AM
authors.lastname: Kats
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pennsylvania.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco.
authors.forename: Charles E
authors.initials: CE
authors.lastname: McCulloch
authors.affiliation: Department of Psychiatry, Department of Neurology and Department of Epidemiology, University of California, San Francisco.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Hillier
authors.affiliation: Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis. Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
mesh_terms: D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D051346:Mobility Limitation; D009026:Mortality / Q000639:trends*; D009483:Neuropsychological Tests; D010641:Phenotype; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Cognitive status; Death; Elderly women; Physical function