Mortality in incident cognitive impairment – Results of the prospective AgeCoDe study

T Luck; SG Riedel-Heller; S Roehr; B Wiese; H Bickel; M Pentzek; HH König; M Scherer; W Maier; S Weyerer

doi:10.1055/s-0037-1605825

Das Gesundheitswesen, Table of Contents

Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605825

Vorträge

Georg Thieme Verlag KG Stuttgart · New York

Mortality in incident cognitive impairment – Results of the prospective AgeCoDe study

T Luck

¹University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig

,

SG Riedel-Heller

¹University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig

,

S Roehr

¹University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig

,

B Wiese

²Hannover Medical School, Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover

,

H Bickel

³Technical University of Munich, Department of Psychiatry, Klinikum rechts der Isar, Munich

,

M Pentzek

⁴Heinrich-Heine-University Düsseldorf, Institute of General Practice, Medical Faculty, Düsseldorf

,

HH König

⁵University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg

,

M Scherer

⁶University Medical Center Hamburg-Eppendorf, Department of Primary Medical Care, Center for Psychosocial Medicine, Hamburg

,

W Maier

⁷Department of Psychiatry, University of Bonn, Bonn

⁸DZNE, German Center for Neurodegenerative Diseases, Bonn

,

S Weyerer

⁹Medical Faculty Mannheim/Heidelberg University, Central Institute of Mental Health, Mannheim

› Author Affiliations

Abstract

Full Text

Objective:

In this study, we aimed at investigating mortality risk in new – incident – cases of cognitive impairment (CI) in a large general practice (GP) patients sample aged 75+ years.

Methods:

Data were derived from the longitudinal German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). We used the Kaplan-Meier survival method to estimate survival times of individuals with and without incident CI and multivariable Cox proportional hazards regressions to assess the association between CI and mortality risk, controlled for covariates.

Results:

Out of the 2,089 included patients at follow-up I, 859 (41.1%) died during the subsequent mean observation period of 8.0 years. Patients with incident CI at follow-up I showed a significantly higher case-fatality rate per 1,000 person-years (74.2, 95%-CI = 64.2 – 84.2 vs. 47.8, 95%-CI = 44.6 – 51.0) and a significantly shorter mean survival time in the observation period than those without (7.8 vs. 9.1 years; P< 0.001). The association between incident CI and mortality remained significant in the multivariable Cox analyses – incident CI was associated with a 42% increased, incident severe CI with a 75% increased mortality risk.

Conclusions:

Our findings suggest an elevated mortality risk in newly acquired cognitive deficits in old age. Even though further studies are required to analyze potential underlying mechanisms, our findings support the notion that such cognitive deficits should be taken seriously in clinical practice not only for an increased risk of developing dementia but also for a broader range of possible adverse health outcomes.