4.4 Article

Associations Between Cognitive Functioning and Mortality in a Population-Based Sample of Older United States Adults: Differences by Sex and Education

Journal

JOURNAL OF AGING AND HEALTH
Volume 34, Issue 6-8, Pages 905-915

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/08982643221076690

Keywords

cognitive function; cognitive status; death and dying; epidemiology; mortality

Funding

  1. National Institute on Minority Health and Health Disparities [K01MD014158]
  2. National Institute on Aging [P30-AG0059304]

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This study found that lower cognitive functioning was associated with increased mortality among older adults in the United States, particularly among women and those with lower education levels.
Objective: To determine whether cognition is associated with mortality among older US adults. Methods: We studied 5,989 National Health and Nutrition Examination Survey participants age 60+ in years 1999-2014 with mortality follow-up through 2015. Cognitive function was measured in one standard deviation decrements using the Digit Symbol Substitution Test (DSST), Animal Fluency (AnFl), and two Consortium to Establish a Registry for Alzheimer's Disease (CERAD) tests. Results: Each decrement in cognitive function was associated with increased risk of mortality overall (DSST HR: 1.36, 95% CI: 1.25, 1.48), among women only (AnFl: 1.51, 95% CI: 1.02, 2.24), and among those with less than a high school education only (AnFl HR: 1.46, 95% CI: 1.09, 1.97; CERAD-WL HR: 1.34, 95% CI: 1.07, 1.67; and CERAD-DR HR: 1.38, 95% CI: 1.05, 1.82). Discussion: Among US adults, lower cognitive functioning was associated with mortality; associations were stronger among women and those with less education.

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