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Level of Cognitive Impairment Predicts Mortality in High-Risk Community Samples: The Memory and Medical Care Study

Received September 22, 2005; revised December 13, 2005; accepted December 30, 2005. Dr. Lee and Ms. Yokley are affiliated with the Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland. Drs. Kasper and Shore are affiliated with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. Drs. Black and Rabins are affiliated with both institutions. Address correspondence to Dr. Lee, The Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 308, Baltimore, MD 21205; Hochang{at}jhmi.edu (E-mail).

ABSTRACT

Over the course of 3 years, the authors investigated the relationship between severity of cognitive impairment and mortality in a community sample of 498 elders at high risk for cognitive impairment. Subjects were classified as having no cognitive disorder, mild cognitive impairment, or dementia, based on a validated battery of four neuropsychological tests. Severity of impairment was based on Mini-Mental State Examination scores. Additional data were obtained from subjects’ knowledgeable informants and Medicare records. Kaplan-Meier survival estimates and Cox hazard proportion analysis of the sample revealed that presence of cognitive impairment increases mortality in a fashion that parallels the severity of the impairment.

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