title: Cognitive Impairment and Disability in Older Japanese Adults.
abstract: The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years) enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs), MCIs with GCI, MCI multiple domain (MCIm), and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8%) experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs) were determined: MCIs (HR, 2.04; 95% CI, 1.39-3.00), MCIs with GCI (HR, 2.10; 95% CI, 1.21-3.62), MCIm (HR, 2.32; 95% CI, 1.39-3.85), and MCIm with GCI (HR, 4.23; 95% CI, 2.73-6.57). These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons.
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Hyuma
authors.initials: H
authors.lastname: Makizako
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Tsutsumimoto
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Sangyoon
authors.initials: S
authors.lastname: Lee
authors.affiliation: National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Gerontology, J.F. Oberlin University Graduate School, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D009483:Neuropsychological Tests; D012307:Risk Factors