Decline in cognitive functioning is associated with a higher mortality risk

Objective: This study investigates the association between 5-year change in cognitive functioning and subsequent mortality. Methods: Four hundred and ninety-three Dutch and Italian men from the Finland, Italy, and the Netherlands Elderly ( FINE) Study, born between 1900 and 1920, participated in the present study between 1990 and 2000. Cognitive functioning was measured with the Mini-Mental State Examination in 1990 and 1995, and mortality data were obtained until the year 2000. A proportional hazard analysis was used to investigate the association between 5-year change in cognitive functioning and subsequent 5-year mortality. Adjustments were made for age, education, country, lifestyle factors, prevalence of chronic diseases and, additionally, for baseline cognitive functioning. Results: Men whose cognition decreased ( more than 1 standard deviation) between 1990 and 1995 had a 2-fold higher risk of dying in the following 5 years compared with men whose cognition was stable (adjusted hazard ratio = 1.9; 95% confidence interval 1.3-2.7). Mortality risk of men whose cognition improved between 1995 and 2000 was not different from men whose cognition was stable (adjusted hazard ratio = 1.1, 95% confidence interval 0.7-1.9). Conclusion: A decline in cognitive functioning is associated with a higher mortality risk. Copyright (c) 2007 S. Karger AG, Basel.