title: Mortality in Incident Cognitive Impairment: Results of the Prospective AgeCoDe Study.
abstract: OBJECTIVE
  To investigate mortality risk and survival time in new-incident cases of cognitive impairment (CI) in old age.
  
  
  METHODS
  Prospective cohort study in six German cities.
  
  
  METHODS
  German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe).
  
  
  METHODS
  Two thousand eighty-nine nondemented GP patients aged 75+.
  
  
  METHODS
  Every 18 months, trained psychologists and physicians conducted structured clinical interviews at the participants' homes. Dates of death were obtained from relatives, general practitioner (GP), or the local registry offices. We used the Kaplan-Meier survival method to estimate survival times of individuals with and without incident CI and multivariable Cox proportional hazards regressions to assess the association between CI and mortality risk, controlled for covariates.
  
  
  RESULTS
  Out of the 2,089 included patients at follow-up I, 859 (41.1%) died during the subsequent mean observation period of 8.0 years. Patients with incident CI at follow-up I showed a significantly higher case-fatality rate per 1,000 person-years (74.2, 95% CI = 64.2-84.2 vs 47.8, 95% CI = 44.6-51.0) and a significantly shorter mean survival time in the observation period than those without (7.8 vs 9.1 years; P < .001). The association between incident CI and mortality remained significant in the multivariable Cox analyses-incident CI was associated with a 42% increased, incident severe CI with a 75% increased mortality risk.
  
  
  CONCLUSIONS
  Our findings suggest an elevated mortality risk in newly acquired cognitive deficits in old age. Even though further studies are required to analyze potential underlying mechanisms, our findings support the notion that such cognitive deficits should be taken seriously in clinical practice not only for an increased risk of developing dementia but also for a broader range of possible adverse health outcomes.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Luck
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Roehr
authors.affiliation: Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany.
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.affiliation: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: van der Leeden
authors.affiliation: Department of Psychiatry, University of Bonn, Bonn, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Heser
authors.affiliation: Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.affiliation: Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.affiliation: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Werle
authors.affiliation: Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Mamone
authors.affiliation: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Mallon
authors.affiliation: Department of Psychiatry, University of Bonn, Bonn, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Wolfsgruber
authors.affiliation: Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Weeg
authors.affiliation: Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christian
authors.identifier: http://orcid.org/0000-0002-5280-1075
authors.initials: C
authors.lastname: Brettschneider
authors.affiliation: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.affiliation: Department of Psychiatry, University of Bonn, Bonn, Germany.|DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.affiliation: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D053208:Kaplan-Meier Estimate; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
keywords: cognitive impairment; dementia; incidence; mortality; survival