Mortality in mild cognitive impairment varies by subtype, sex, and lifestyle factors: The mayo clinic study of aging

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Abstract

Background: Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective: To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods: Participants aged 70-89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases versus cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results: Over a median follow-up of 5.8 years, 331 of 862 (38.4%) MCI cases and 224 of 1,292 (17.3%) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 1.79; 95% CI: 1.41 to 2.27), and was higher for non-amnestic MCI (naMCI; HR = 2.40; 95% CI: 1.72 to 3.36) than for amnestic MCI (aMCI; HR = 1.61; 95% CI: 1.25 to 2.09) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education versus CN without these factors, and for naMCI cases versus aMCI cases without these factors. Conclusions: These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality and delayed MCI diagnosis in persons with higher education impacts mortality.

Original languageEnglish (US)
Pages (from-to)1237-1245
Number of pages9
JournalJournal of Alzheimer's Disease
Volume45
Issue number4
DOIs
StatePublished - 2015

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Sex Factors
Life Style
Mortality
Heart Diseases
Exercise
Cognitive Dysfunction
Education
Sex Education
Proportional Hazards Models
Dementia

Keywords

  • Cohort studies
  • incidence studies
  • mild cognitive impairment
  • mortality
  • outcomes research
  • prognosis

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology

Cite this

@article{424c8e47430d44e785012958710f2e85,
title = "Mortality in mild cognitive impairment varies by subtype, sex, and lifestyle factors: The mayo clinic study of aging",
abstract = "Background: Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective: To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods: Participants aged 70-89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases versus cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results: Over a median follow-up of 5.8 years, 331 of 862 (38.4{\%}) MCI cases and 224 of 1,292 (17.3{\%}) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 1.79; 95{\%} CI: 1.41 to 2.27), and was higher for non-amnestic MCI (naMCI; HR = 2.40; 95{\%} CI: 1.72 to 3.36) than for amnestic MCI (aMCI; HR = 1.61; 95{\%} CI: 1.25 to 2.09) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education versus CN without these factors, and for naMCI cases versus aMCI cases without these factors. Conclusions: These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality and delayed MCI diagnosis in persons with higher education impacts mortality.",
keywords = "Cohort studies, incidence studies, mild cognitive impairment, mortality, outcomes research, prognosis",
author = "Maria Vassilaki and Cha, {Ruth H.} and Geda, {Yonas Endale} and Mielke, {Michelle M} and Knopman, {David S} and Petersen, {Ronald Carl} and Roberts, {Rosebud O}",
year = "2015",
doi = "10.3233/JAD-143078",
language = "English (US)",
volume = "45",
pages = "1237--1245",
journal = "Journal of Alzheimer's Disease",
issn = "1387-2877",
publisher = "IOS Press",
number = "4",

}

TY - JOUR

T1 - Mortality in mild cognitive impairment varies by subtype, sex, and lifestyle factors

T2 - The mayo clinic study of aging

AU - Vassilaki, Maria

AU - Cha, Ruth H.

AU - Geda, Yonas Endale

AU - Mielke, Michelle M

AU - Knopman, David S

AU - Petersen, Ronald Carl

AU - Roberts, Rosebud O

PY - 2015

Y1 - 2015

N2 - Background: Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective: To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods: Participants aged 70-89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases versus cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results: Over a median follow-up of 5.8 years, 331 of 862 (38.4%) MCI cases and 224 of 1,292 (17.3%) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 1.79; 95% CI: 1.41 to 2.27), and was higher for non-amnestic MCI (naMCI; HR = 2.40; 95% CI: 1.72 to 3.36) than for amnestic MCI (aMCI; HR = 1.61; 95% CI: 1.25 to 2.09) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education versus CN without these factors, and for naMCI cases versus aMCI cases without these factors. Conclusions: These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality and delayed MCI diagnosis in persons with higher education impacts mortality.

AB - Background: Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective: To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods: Participants aged 70-89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases versus cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results: Over a median follow-up of 5.8 years, 331 of 862 (38.4%) MCI cases and 224 of 1,292 (17.3%) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 1.79; 95% CI: 1.41 to 2.27), and was higher for non-amnestic MCI (naMCI; HR = 2.40; 95% CI: 1.72 to 3.36) than for amnestic MCI (aMCI; HR = 1.61; 95% CI: 1.25 to 2.09) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education versus CN without these factors, and for naMCI cases versus aMCI cases without these factors. Conclusions: These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality and delayed MCI diagnosis in persons with higher education impacts mortality.

KW - Cohort studies

KW - incidence studies

KW - mild cognitive impairment

KW - mortality

KW - outcomes research

KW - prognosis

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U2 - 10.3233/JAD-143078

DO - 10.3233/JAD-143078

M3 - Article

C2 - 25697699

AN - SCOPUS:84928130105

VL - 45

SP - 1237

EP - 1245

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

SN - 1387-2877

IS - 4

ER -