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Predictors of Cognitive Decline and Mortality of Aged People Over a 10-Year Period

Predictors of Cognitive Decline and Mortality of Aged People Over a 10-Year Period Background . The search for preventable and remediable risk conditions of cognitive decline is ongoing, but results have thus far been inconsistent. According to the hypothesis of our 10-year prospective study, the predictive values of different risk indicators change over time in a general 75+ population. Methods . A population-based sample of 75-, 80-, and 85-year-old individuals ( n = 650) underwent comprehensive clinical examinations in 1990 in Helsinki, Finland. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and/or Clinical Dementia Rating (CDR) at baseline and after 1, 5, and 10 years. Results . At baseline, a low MMSE score was associated with age, history of stroke, apolipoprotein E allele ε4 (APOE4), and intermittent claudication. After 1 year, cognitive decline was typical of participants suffering from vascular diseases, e.g., heart failure and intermittent claudication. Five-year decline was predicted by the presence of atrial fibrillation (RR (relative risk) 2.8), APOE4 (RR 2.4), elevated C-reactive protein (CRP) (RR 2.3), diabetes mellitus (RR 2.2), and heart failure (RR 1.8). They also tended to increase 5-year all-cause mortality. At 10 years, the decline associated with APOE4 (RR 3.3), slightly elevated serum ionized calcium (RR 3.3), and feelings of loneliness (RR 3.0). Conclusions . Long follow-up of a general aged population explains several inconsistencies of earlier reports. In 75+ individuals, general ill health is a strong associate of cognitive deficits. The strongest predictors of both cognitive decline and mortality are age, APOE4, manifest vascular diseases, and diabetes. The role of new potential predictors, feelings of loneliness and hypercalcemia, needs clinical testing. The Gerontological Society of America « Previous | Next Article » Table of Contents This Article J Gerontol A Biol Sci Med Sci (2004) 59 (3): M268-M274. doi: 10.1093/gerona/59.3.M268 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Journal of Gerontology: Medical Sciences Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Tilvis, R. S. Articles by Strandberg, T. E. Search for related content PubMed PubMed citation Articles by Tilvis, R. S. Articles by Kähönen-Väre, M. H. Articles by Jolkkonen, J. Articles by Valvanne, J. Articles by Pitkala, K. H. Articles by Strandberg, T. E. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 2015 70 (11) Alert me to new issues The Journal About the journal Translational Articles Free Editors’ Choice Articles Impact Factor Articles The Journals of Gerontology, Series A Supplements Special Issues Rights & permissions We are mobile – find out more Journal Career Network Published on behalf of The Gerontological Society of America Impact Factor: 5.416 5-Yr impact factor: 5.406 Editorial Boards The Journals of Gerontology, Series A: Biological Sciences Rafael de Cabo, PhD, Editor View full editorial board The Journals of Gerontology, Series A: Medical Sciences Stephen B. Kritchevsky, PhD View full editorial board For the Media GSA Press Room For Authors Instructions to authors Services for authors Submit Now: Biological Sciences Submit Now: Medical Sciences Self-Archiving Policy Online Submission Open access options for authors - visit Oxford Open WhsSvhnOkaAwYG81FJCYgwG7z1LnIP2F true Looking for your next opportunity? Looking for jobs... jQuery_1_11 = jQuery.noConflict(true); Corporate Services What we offer Advertising sales Reprints Supplements Classified Advertising Sales Alerting Services Email table of contents CiteTrack XML RSS feed var taxonomies = ("MED00280", "SCI00960"); Most Most Read A Genetic Network Associated With Stress Resistance, Longevity, and Cancer in Humans A 2-Year Randomized Controlled Trial of Human Caloric Restriction: Feasibility and Effects on Predictors of Health Span and Longevity Frailty in Older Adults: Evidence for a Phenotype Nutrition, Physical Activity, and Quality of Life in Older Adults: Summary The Top 10 Hot Topics in Aging » View all Most Read articles Most Cited Frailty in Older Adults: Evidence for a Phenotype Lower Extremity Function and Subsequent Disability: Consistency Across Studies, Predictive Models, and Value of Gait Speed Alone Compared With the Short Physical Performance Battery The Loss of Skeletal Muscle Strength, Mass, and Quality in Older Adults: The Health, Aging and Body Composition Study Muscle Mass, Muscle Strength, and Muscle Fat Infiltration as Predictors of Incident Mobility Limitations in Well-Functioning Older Persons Strength, But Not Muscle Mass, Is Associated With Mortality in the Health, Aging and Body Composition Study Cohort » View all Most Cited articles Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department. Online ISSN 1758-535X - Print ISSN 1079-5006 Copyright © 2015 The Gerontological Society of America Oxford Journals Oxford University Press Site Map Privacy Policy Cookie Policy Legal Notices Frequently Asked Questions Other Oxford University Press sites: Oxford University Press Oxford Journals China Oxford Journals Japan Academic & Professional books Children's & Schools Books Dictionaries & Reference Dictionary of National Biography Digital Reference English Language Teaching Higher Education Textbooks International Education Unit Law Medicine Music Online Products & Publishing Oxford Bibliographies Online Oxford Dictionaries Online Oxford English Dictionary Oxford Language Dictionaries Online Oxford Scholarship Online Reference Rights and Permissions Resources for Retailers & Wholesalers Resources for the Healthcare Industry Very Short Introductions World's Classics function fnc_onDomLoaded() { var query_context = getQueryContext(); PF_initOIUnderbar(query_context,":QS:default","","JRN"); PF_insertOIUnderbar(0); }; if (window.addEventListener) { window.addEventListener('load', fnc_onDomLoaded, false); } else if (window.attachEvent) { window.attachEvent('onload', fnc_onDomLoaded); } var gaJsHost = (("https:" == document.location.protocol) ? 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Publisher
Oxford University Press
Copyright
Copyright © 2015 The Gerontological Society of America
ISSN
1079-5006
eISSN
1758-535X
DOI
10.1093/gerona/59.3.M268
Publisher site
See Article on Publisher Site

Abstract

Background . The search for preventable and remediable risk conditions of cognitive decline is ongoing, but results have thus far been inconsistent. According to the hypothesis of our 10-year prospective study, the predictive values of different risk indicators change over time in a general 75+ population. Methods . A population-based sample of 75-, 80-, and 85-year-old individuals ( n = 650) underwent comprehensive clinical examinations in 1990 in Helsinki, Finland. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and/or Clinical Dementia Rating (CDR) at baseline and after 1, 5, and 10 years. Results . At baseline, a low MMSE score was associated with age, history of stroke, apolipoprotein E allele ε4 (APOE4), and intermittent claudication. After 1 year, cognitive decline was typical of participants suffering from vascular diseases, e.g., heart failure and intermittent claudication. Five-year decline was predicted by the presence of atrial fibrillation (RR (relative risk) 2.8), APOE4 (RR 2.4), elevated C-reactive protein (CRP) (RR 2.3), diabetes mellitus (RR 2.2), and heart failure (RR 1.8). They also tended to increase 5-year all-cause mortality. At 10 years, the decline associated with APOE4 (RR 3.3), slightly elevated serum ionized calcium (RR 3.3), and feelings of loneliness (RR 3.0). Conclusions . Long follow-up of a general aged population explains several inconsistencies of earlier reports. In 75+ individuals, general ill health is a strong associate of cognitive deficits. The strongest predictors of both cognitive decline and mortality are age, APOE4, manifest vascular diseases, and diabetes. The role of new potential predictors, feelings of loneliness and hypercalcemia, needs clinical testing. The Gerontological Society of America « Previous | Next Article » Table of Contents This Article J Gerontol A Biol Sci Med Sci (2004) 59 (3): M268-M274. doi: 10.1093/gerona/59.3.M268 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Journal of Gerontology: Medical Sciences Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Tilvis, R. S. Articles by Strandberg, T. E. Search for related content PubMed PubMed citation Articles by Tilvis, R. S. Articles by Kähönen-Väre, M. H. Articles by Jolkkonen, J. Articles by Valvanne, J. Articles by Pitkala, K. H. Articles by Strandberg, T. E. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 2015 70 (11) Alert me to new issues The Journal About the journal Translational Articles Free Editors’ Choice Articles Impact Factor Articles The Journals of Gerontology, Series A Supplements Special Issues Rights & permissions We are mobile – find out more Journal Career Network Published on behalf of The Gerontological Society of America Impact Factor: 5.416 5-Yr impact factor: 5.406 Editorial Boards The Journals of Gerontology, Series A: Biological Sciences Rafael de Cabo, PhD, Editor View full editorial board The Journals of Gerontology, Series A: Medical Sciences Stephen B. Kritchevsky, PhD View full editorial board For the Media GSA Press Room For Authors Instructions to authors Services for authors Submit Now: Biological Sciences Submit Now: Medical Sciences Self-Archiving Policy Online Submission Open access options for authors - visit Oxford Open WhsSvhnOkaAwYG81FJCYgwG7z1LnIP2F true Looking for your next opportunity? Looking for jobs... jQuery_1_11 = jQuery.noConflict(true); Corporate Services What we offer Advertising sales Reprints Supplements Classified Advertising Sales Alerting Services Email table of contents CiteTrack XML RSS feed var taxonomies = ("MED00280", "SCI00960"); Most Most Read A Genetic Network Associated With Stress Resistance, Longevity, and Cancer in Humans A 2-Year Randomized Controlled Trial of Human Caloric Restriction: Feasibility and Effects on Predictors of Health Span and Longevity Frailty in Older Adults: Evidence for a Phenotype Nutrition, Physical Activity, and Quality of Life in Older Adults: Summary The Top 10 Hot Topics in Aging » View all Most Read articles Most Cited Frailty in Older Adults: Evidence for a Phenotype Lower Extremity Function and Subsequent Disability: Consistency Across Studies, Predictive Models, and Value of Gait Speed Alone Compared With the Short Physical Performance Battery The Loss of Skeletal Muscle Strength, Mass, and Quality in Older Adults: The Health, Aging and Body Composition Study Muscle Mass, Muscle Strength, and Muscle Fat Infiltration as Predictors of Incident Mobility Limitations in Well-Functioning Older Persons Strength, But Not Muscle Mass, Is Associated With Mortality in the Health, Aging and Body Composition Study Cohort » View all Most Cited articles Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department. Online ISSN 1758-535X - Print ISSN 1079-5006 Copyright © 2015 The Gerontological Society of America Oxford Journals Oxford University Press Site Map Privacy Policy Cookie Policy Legal Notices Frequently Asked Questions Other Oxford University Press sites: Oxford University Press Oxford Journals China Oxford Journals Japan Academic & Professional books Children's & Schools Books Dictionaries & Reference Dictionary of National Biography Digital Reference English Language Teaching Higher Education Textbooks International Education Unit Law Medicine Music Online Products & Publishing Oxford Bibliographies Online Oxford Dictionaries Online Oxford English Dictionary Oxford Language Dictionaries Online Oxford Scholarship Online Reference Rights and Permissions Resources for Retailers & Wholesalers Resources for the Healthcare Industry Very Short Introductions World's Classics function fnc_onDomLoaded() { var query_context = getQueryContext(); PF_initOIUnderbar(query_context,":QS:default","","JRN"); PF_insertOIUnderbar(0); }; if (window.addEventListener) { window.addEventListener('load', fnc_onDomLoaded, false); } else if (window.attachEvent) { window.attachEvent('onload', fnc_onDomLoaded); } var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); try { var pageTracker = _gat._getTracker("UA-189672-16"); pageTracker._setDomainName(".oxfordjournals.org"); pageTracker._trackPageview(); } catch(err) {}

Journal

The Journals of Gerontology Series A: Biomedical Sciences and Medical SciencesOxford University Press

Published: Mar 1, 2004

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