Understanding the relationship between cognition and death: a within cohort examination of cognitive measures and mortality.

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Luben, Robert 
Dalzell, Nichola 
Moore, Stephanie 
Hogervorst, Eef 

Despite several studies demonstrating an independent and inverse association between cognition and mortality, the nature of this association still remains unclear. To examine the association of cognition and mortality after accounting for sociodemographic, health and lifestyle factors and to explore both test and population characteristics influencing this relationship. In a population based cohort of 8585 men and women aged 48-92 years, who had cognitive assessments in 2006-2011 and were followed up till 2016 for mortality, we examined the relationship between individual cognitive tests as well as a global cognition score to compare their ability in predicting mortality and whether these differed by population characteristics. Risk of death was estimated using Cox proportional hazard regression models including sociodemographic, lifestyle and health variables, and self-reported comorbidities, as covariates in the models. Poor cognitive performance (bottom quartile of combined cognition score) was associated with higher risk of mortality, Hazard Ratio = 1.32 (95% Confidence Interval 1.09, 1.60); individual cognitive tests varied in their mortality associations and also performed differently in middle-age and older age groups. Poor cognitive performance is independently associated with higher mortality. This association is observed for global cognition and for specific cognitive abilities. Associations vary depending on the cognitive test (and domain) as well as population characteristics, namely age and education.

Cognitive function, Epidemiology, Mortality, Population, Aged, Aged, 80 and over, Aging, Cognition, Cognition Disorders, Cognitive Aging, Cohort Studies, Female, Humans, Male, Middle Aged, Mortality, Risk, United Kingdom
Journal Title
Eur J Epidemiol
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Springer Science and Business Media LLC
Medical Research Council (G1000143)
Medical Research Council (MR/N003284/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0512-10135)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Medical Research Council (G0401527)
Medical Research Council (MC_UU_12015/1)
Cancer Research Uk (None)
Cancer Research Uk (None)
This work was supported by the Medical Research Council, UK http://www.mrc.ac.uk/ (Ref: G0401527) and Cancer Research UK http://www.cancerresearchuk. org/ (CRUK, Ref: C864/A8257). The clinic for EPIC- Norfolk 3 was funded by Research into Ageing, now known as Age UK http://www.ageuk.org.uk/ (Grant Ref: 262). The pilot phase was supported by MRC (Ref: G9502233) and CRUK (Ref: C864/ A2883). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.