Association between mild cognitive impairment and all-cause death in community-dwelling middle-aged and older adults / 中华老年医学杂志

ABSTRACT

Objective:To explore the association between mild cognitive impairment(MCI)and the risk of all-cause death among community middle-aged and older adults, and to provide evidence for early identification of high-risk populations.Methods:From September to November 2011, the residents aged 55 years and middle-aged and older in five urban communities were selected as the research objects by typical sampling method.The baseline survey of general information questionnaire, Mini-Mental State Examination(MMSE), activity of daily Living Scale(ADL), Geriatric Depression Scale(SDS)was carried out and the physical examination was performed.Mild cognitive impairment at the time of enrollment was the exposure factor.In 2017, 2019 and 2021, Deaths were followed up through home visits and search for death surveillance information systems.COX regression model was used to analyze the influencing factors for death.Results:A total of 1046 participants completed the follow-up and were included in the study.The baseline age was(66.4±6.6)years, and 199(19.0%)of them met the criteria for MCI.The average follow-up time was 112±16 months.During the follow-up period, 106 deaths were observed.The mortality rate was higher in participants with MCI(40 deaths, 21.1%)than those without MCI [(66 deaths, 10.1%), χ2=26.80, P<0.001)]. Participants with MCI had a shorter median survival time than those without MCI[(108.0±1.5) vs.(113.0±0.5)months, χlog-rank2=28.02, P<0.001]using the Kaplan-Meier method.Controlling for gender, age, and ethnicity, the Cox regression model revealed that MCI is associated with an increased risk of all-cause death( HR=1.98, 95% CI 1.30-3.02, P=0.023). Conclusions:Mild cognitive impairment is an independent risk factor for all-cause death among community older adults.Early identification and intervention of MCI may have potential value in preventing premature death and prolonging life in middle-aged and older adults.