Plasma selenium over time and cognitive decline in the elderly

BACKGROUND: Because brain oxidative stress is a cause of cognitive impairment, selenium, which is an antioxidant, may protect against cognitive decline. The aim of the study was to examine whether declining selenium levels over time are associated with cognitive decline in a cohort of community-dwelling French elderly. METHODS: During 1991-1993, 1389 subjects (age 60-71 years) were recruited into a 9-year longitudinal study with 6 waves of follow-up. Cognitive functions were evaluated by neuropsychologic tests. To take into account the entire set of cognitive measurements and the within-subject correlations between measures, we analyzed mixed linear and logistic models to study associations between selenium change and cognitive decline. RESULTS: After controlling for potential confounders, cognitive decline was associated with decreases of plasma selenium over time. Among subjects who had a decrease in their plasma selenium levels, the greater the decrease in plasma selenium, the higher the probability of cognitive decline. Among subjects who had an increase in their plasma selenium levels, cognitive decline was greater in subjects with the smallest selenium increase. There was no association between short-term (2-year) selenium change and cognitive changes. CONCLUSION: Selenium status decreases with age and may contribute to declines in neuropsychologic functions among aging people.     

A change point model for estimating the onset of cognitive decline in preclinical Alzheimer's disease

Dementia is characterized by accelerated cognitive decline before and after diagnosis as compared to normal ageing. Determining the time at which that rate of decline begins to accelerate in persons who will develop dementia is important both in describing the natural history of the disease process and in identifying the optimal time window for which treatments might be useful. We model that time at which the rate of decline begins to accelerate in persons who develop dementia relative to those who do not by using a change point in a mixed linear model. A profile likelihood method is proposed to draw inferences about the change point. The method is applied to data from the Bronx Ageing Study, a cohort study of 488 initially non-demented community-dwelling elderly individuals who have been examined at approximately 12-month intervals over 15 years. Cognitive function was measured using the Buschke Selective Reminding test, a memory test with high reliability and known discriminative validity for detecting dementia. We found that the rate of cognitive decline as measured by this test in this cohort increases on average 5.1 years before the diagnosis of dementia.     

Fruit and vegetable intake and cognitive decline in middle-aged men and women: the Doetinchem Cohort Study

To postpone cognitive decline and dementia in old age, primary prevention is required earlier in life during middle age. Dietary components may be modifiable determinants of mental performance. In the present study, habitual fruit and vegetable intake was studied in association with cognitive function and cognitive decline during middle age. In the Doetinchem Cohort Study, 2613 men and women aged 43-70 years at baseline (1995-2002) were examined for cognitive function twice, with a 5-year time interval. Global cognitive function and the domains memory, information processing speed and cognitive flexibility were assessed. Dietary intake was assessed with a semi-quantitative FFQ. In multivariate linear regression analyses, habitual fruit and vegetable intake was studied in association with baseline and change in cognitive function. Higher reported vegetable intake was associated with lower information processing speed (P = 0·02) and worse cognitive flexibility (P = 0·03) at baseline, but with smaller decline in information processing speed (P < 0·01) and global cognitive function (P = 0·02) at follow-up. Total intakes of fruits, legumes and juices were not associated with baseline or change in cognitive function. High intakes of some subgroups of fruits and vegetables (i.e. nuts, cabbage and root vegetables) were associated with better cognitive function at baseline and/or smaller decline in cognitive domains. In conclusion, total intake of fruits and vegetables was not or inconsistently associated with cognitive function and cognitive decline. A high habitual consumption of some specific fruits and vegetables may diminish age-related cognitive decline in middle-aged individuals. Further research is needed to verify these findings before recommendations can be made.     

Cognitive impairment and mortality: a study of possible confounders

Baseline neuropsychological function was assessed in 2,123 Framingham Heart Study participants and was related to mortality over an 8- to 10-year follow-up period. During that time, 573 persons died. Using Cox proportional hazards models, the authors showed poor cognitive function to be consistently associated with an increased risk of death. This association persisted after adjustment for the confounding effects of age, education, and illness. Subjects scoring below the 26th percentile of performance were at increased risk of mortality compared with high scorers (the relative risk was 1.3 for the 11th percentile-25th percentile and 1.7 for the 1st percentile-10th percentile).     

The implications of body fat mass and fat distribution for cognitive function in elderly women

OBJECTIVE: To investigate how body fat mass, an established source of endogenous estrogen after menopause, influences cognitive impairment in elderly women. RESEARCH METHODS AND PROCEDURES: Study participants were 5607 generally healthy postmenopausal women with mean age of 63.8 years at baseline followed for an average of 7.3 years. Cognitive function assessed at follow-up using the short Blessed test was related to baseline body weight, the yearly change in weight, and follow-up measures of body fat depots assessed by DXA. Cognitive function was also related to various surrogates of lifetime estrogen exposure. RESULTS: Women with the worst cognitive performance (score >or= 9) at follow-up were the ones who lost the most body weight and revealed the lowest central fat mass (CFM). The association of weight loss with worse cognitive performance was apparent across all age groups except for those more than 80 years old. In the multivariate logistic model, the risk of cognitive impairment was 18% lower in women in the second quartile of CFM (p = 0.14), 32% lower in the third (p = 0.01), and 48% lower in the fourth (p < 0.001) compared with those in the first quartile. CFM showed significant correlation with the simultaneously measured serum estradiol (r = 0.25; p < 0.001). Cognitive score showed an inverse linear relationship with the duration of reproductive period and bone mineral density assessed at follow-up. DISCUSSION: These findings argue for a protective association of body fat mass with cognitive impairment in elderly women. This association seems to involve a more prominent exposure to endogenous estrogens.     

Cannabis use and cognitive decline in persons under 65 years of age

The purpose of this study was to investigate possible adverse effects of cannabis use on cognitive decline after 12 years in persons under age 65 years. This was a follow-up study of a probability sample of the adult household residents of East Baltimore. The analyses included 1,318 participants in the Baltimore, Maryland, portion of the Epidemiologic Catchment Area study who completed the Mini-Mental State Examination (MMSE) during three study waves in 1981, 1982, and 1993-1996. Individual MMSE score differences between waves 2 and 3 were calculated for each study participant. After 12 years, study participants' scores declined a mean of 1.20 points on the MMSE (standard deviation 1.90), with 66% having scores that declined by at least one point. Significant numbers of scores declined by three points or more (15% of participants in the 18-29 age group). There were no significant differences in cognitive decline between heavy users, light users, and nonusers of cannabis. There were also no male-female differences in cognitive decline in relation to cannabis use. The authors conclude that over long time periods, in persons under age 65 years, cognitive decline occurs in all age groups. This decline is closely associated with aging and educational level but does not appear to be associated with cannabis use.     

Physical Frailty is Associated with Longitudinal Decline in Global Cognitive Function in Non-Demented Older Adults: A Prospective Study

Objectives

To assess the relationship between physical frailty and subsequent decline in global cognitive function in the non-demented elderly.

Design and setting

A prospective population-based study in a west Japanese suburban town, with two-year follow-up.

Participants

Community-dwellers aged 65 and older without placement in long-term care, and not having a history of dementia, Parkinson’s disease and depression at baseline, who participated in the cohort of the Sasaguri Genkimon Study and underwent follow-up assessments two years later (N = 1,045).

Measurements

Global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Physical frailty was identified according to the following five components: weight loss, low grip strength, exhaustion, slow gait speed and low physical activities. Linear regression models were used to examine associations between baseline frailty status and the MoCA scores at follow-up. Logistic regression models were used to estimate the risk of cognitive decline (defined as at least two points decrease of MoCA score) according to baseline frailty status.

Results

Seven hundred and eight non-demented older adults were included in the final analyses (mean age: 72.6 ± 5.5 years, male 40.3%); 5.8% were frail, and 40.8% were prefrail at baseline. One hundred and fifty nine (22.5%) participants experienced cognitive decline over two years. After adjustment for baseline MoCA scores and all confounders, being frail at baseline was significantly associated with a decline of 1.48 points (95% confidence interval [CI], -2.37 to -0.59) in MoCA scores, as compared with non-frailty. Frail persons were over two times more likely to experience cognitive decline (adjusted odds ratio 2.28; 95% CI, 1.02 to 5.08), compared to non-frail persons.

Conclusion

Physical frailty is associated with longitudinal decline in global cognitive function in the non-demented older adults over a period of two years. Physically frail older community-dwellers should be closely monitored for cognitive decline that can be sensitively captured by using the MoCA.

     

Early life conditions and cognitive functioning in later life

Early life conditions are related to cognitive development and abilities in childhood and cognitive function in adulthood. However, the association between early life conditions and cognitive change in old age is unknown. The authors examined the relation between socioeconomic position (SEP) and cognitive milieu in childhood and change in cognitive function in a population-based sample of 4,398 community-dwelling adults (62.1% female; 61.7% Black) aged 65 years or older from Chicago, Illinois. Baseline data were collected in 1993-1997. Change in cognitive function was assessed by means of a global cognitive index derived from measures of memory, perceptual speed, and overall cognitive function administered at three in-home assessments between 1993 and 2003, with an average of 5.3 years of follow-up. After results were controlled for age, sex, race, and education, interactions of time with childhood SEP (beta = -0.003, t = -1.0, p = 0.32) and childhood cognitive milieu (beta = -0.0008, t = -0.5, p = 0.62) were nonsignificant, indicating that early life conditions were not related to cognitive change. SEP (beta = 0.034, t = 2.4, p = 0.01) and cognitive milieu (beta = 0.017, t = 2.2, p = 0.03) were associated with absolute level of cognitive function, with better performance being related to higher SEP and a better cognitive milieu. A better SEP and a more stimulating cognitive milieu in childhood have small but significant effects on absolute level of cognitive function; however, they do not seem to protect against cognitive decline in old age.     

Relative weight and mobility: a longitudinal study in a biracial population of older adults

PURPOSE: We examined the association of relative weight with mobility and changes in mobility over time and whether these associations differed by race. METHODS: Data come from a prospective, population-based, observational study of adults aged 65 years or older. Mobility outcomes were assessed at baseline and two follow-up interviews at 3-year intervals. The study included 4195 participants with a mean age of 73.8 +/- 6.3 (SD) years; 61.4% were women, and 60.9% were black. Assessment of mobility included a brief self-report instrument and a performance-based walk test. Body mass index (BMI, kilograms per square meter) was used as a measure of relative weight. We used generalized estimating equation models to examine change in mobility outcomes over time as a function of BMI. RESULTS: Average BMI was 26.6 +/- 5.7 kg/m(2), with 34.0% overweight and 23.4% obese. BMI showed a significant curvilinear association with mobility outcomes at baseline (p < 0.001), but was not associated with change in mobility during follow-up. Maximum mobility levels occurred at a significantly higher level of BMI among blacks than whites. CONCLUSIONS: Higher levels of BMI may lead to mobility impairments earlier in life, but there is little evidence that they increase the rate of decline in mobility in older age itself.     

中国9个长寿地区65岁及以上人群血氧饱和度对死亡风险的影响

目的探讨65岁及以上人群血氧饱和度(S_pO₂)与3年全死因死亡风险的关系。方法研究对象来自2012-2014年在我国9个长寿地区开展的“老年健康生物标志物队列研究”,基于前瞻性队列研究,将2287名65岁及以上老年人群纳入研究。在2012年基线时收集调查对象SpO2、身体测量指标等数据,2014年随访时收集生存结局和死亡时间等数据。根据调查对象SpO2是否异常(SpO2<94%定义为异常)将其分为2组,采用Cox比例风险回归模型分析SpO2对死亡风险的影响。结果2287名研究对象年龄为(86.5±12.2)岁,男性1006名(44.0%);SpO2异常者315例(13.8%)。2014年随访时,452例死亡,1434例存活,401例失访,全死因死亡率为19.8%,随访率为82.5%。调整相关混杂因素后,与SpO2正常组相比,异常组死亡风险升高,HR(95%CI)为1.62(1.31~2.02);其中异常组男性死亡风险HR(95%CI)为1.49(0.98~2.26),女性为1.71(1.30~2.26);65~79、80~89、90岁及以上人群死亡风险HR(95%CI)分别为2.70(0.98~7.44)、1.22(0.63~2.38)、1.72(1.35~2.19)。结论SpO2异常可增加我国长寿地区老年人3年死亡风险。     

Coffee consumption is inversely associated with cognitive decline in elderly European men: the FINE Study

OBJECTIVE: To investigate whether coffee consumption is associated with 10-year cognitive decline in elderly men, as results of previous studies obtained hitherto have been controversial and prospective information on this association has been lacking. DESIGN, SUBJECTS AND SETTING: Six hundred and seventy six healthy men born between 1900 and 1920 from Finland, Italy and the Netherlands participated in a 10-year prospective cohort study. Cognitive functioning was assessed using the Mini-Mental State Examination (0-30 points, with a higher score indicating better cognitive performance). Coffee consumption was estimated in cups per day. A mixed longitudinal model was used to investigate the association between baseline coffee consumption and 10-year cognitive decline. Multiple adjustments were made. RESULTS: Men who consumed coffee had a 10-year cognitive decline of 1.2 points (4%). Non-consumers had an additional decline of 1.4 points (P<0.001). An inverse and J-shaped association was observed between the number of cups of coffee consumed and cognitive decline, with the least cognitive decline for three cups of coffee per day (0.6 points). This decline was 4.3 times smaller than the decline of non-consumers (P<0.001). CONCLUSIONS: Findings suggest that consuming coffee reduces cognitive decline in elderly men. An inverse and J-shaped association may exist between the number of cups of coffee consumed and cognitive decline, with the least cognitive decline for men consuming three cups of coffee per day.     

Flavonoid intake and cognitive decline over a 10-year period

In the PAQUID (Personnes Agées Quid) study, the authors prospectively examined flavonoid intake in relation to cognitive function and decline among subjects aged 65 years or older. A total of 1,640 subjects free from dementia at baseline in 1990 and with reliable dietary assessment were reexamined four times over a 10-year period. Cognitive functioning was assessed through three psychometric tests (Mini-Mental State Examination, Benton's Visual Retention Test, "Isaacs" Set Test) at each visit. Information on flavonoid intake was collected at baseline. A linear mixed model was used to analyze the evolution of cognitive performance according to quartiles of flavonoid intake. After adjustment for age, sex, and educational level, flavonoid intake was associated with better cognitive performance at baseline (p = 0.019) and with a better evolution of the performance over time (p = 0.046). Subjects included in the two highest quartiles of flavonoid intake had better cognitive evolution than did subjects in the lowest quartile. After 10 years' follow-up, subjects with the lowest flavonoid intake had lost on average 2.1 points on the Mini-Mental State Examination, whereas subjects with the highest quartile had lost 1.2 points. This gradient persisted after adjustment for several other potential confounders. This study raises the possibility that dietary flavonoid intake is associated with better cognitive evolution.     

Cognitive impairment and mortality in the community-dwelling elderly

The effects on mortality of cognitive impairment and 3-year declines in cognitive function were examined among community-dwelling adults aged 68 years or more. Data were taken from a population-based cohort study that enrolled noninstitutionalized elderly residents of New Haven, Connecticut, and followed them by conducting in-home interviews in 1982, 1985, 1988, and 1994. The cognitive function of 1,997 respondents was assessed by using the 30-point Mini-Mental State Examination in 1985; 1,372 respondents (86% of those alive) were retested in 1988. Responses were classified as high normal (28-30), low normal (24-27), mild impairment (18-23), or severe impairment (0-17); cognitive decline was defined as a transition to a lower category. After control for multiple potential confounders, both severe and mild cognitive impairment were strongly predictive of subsequent mortality among respondents aged less than 80 years. Upon closer examination, the elevated mortality risk was observed primarily among respondents whose cognitive decline was recent rather than among those whose cognitive performance was compromised but stable. Among respondents aged 80 years or more, declines to severe cognitive impairment were predictive of mortality, but it was not clear whether the decline per se signaled an unfavorable prognosis not accounted for by the resulting impairment level. Cognitive declines, especially those in the young elderly, have a marked adverse impact on survival.     

Plasma vitamin d levels and cognitive function in aging women: The nurses’ health study

Background

Vitamin D may play a role in preserving cognitive function. However, there is a paucity of prospective studies on the relationship between vitamin D and cognition with aging. The aim of this study was to examine the association between plasma levels of vitamin D and subsequent cognitive function.

Methods

This is a prospective study including 1,185 women aged 60–70 years from the Nurses’ Health Study, who had plasma 25-hydroxy-vitamin D levels measured in 1989–1990 and completed an initial Telephone Interview of Cognitive Status approximately 9 years later. Subsequently, three follow-up cognitive assessments were conducted at 1.5–2.0 years intervals. We used multivariable-adjusted linear regression to model initial cognitive function, and mixed linear regression to model change in cognitive function over time.

Results

Lower vitamin D levels were associated with significantly worse cognitive function 9 years later. For example, the mean global composite score averaging all the cognitive tests was 0.20 lower (95% Confidence Interval (CI):?0.33,?0.08; p-trend=0.009) in women in the lowest quintile (median=14.1 ng/mL) compared with women in the highest quintile of vitamin D (median=38.4 ng/mL). The observed differences were equivalent to the effect estimates we found for women who were approximately 4–6 years apart in age. However, vitamin D levels were not significantly associated with subsequent cognitive decline during 6 years of follow-up.

Conclusions

Higher levels of plasma vitamin D in women aged 60–70 years were associated with better cognitive function about a decade later but were not associated with cognitive decline during 6 years of follow-up.     

Lower intake of vegetables and legumes associated with cognitive decline among illiterate elderly Chinese: A 3-year cohort study

Background

Despite many studies on cognitive function and its influential factors among old population, relatively little research has been designed to study the relationship between dietary intake and cognitive function in elderly.

Objective

We conducted a population-based, prospective nested case-control study to investigate the association between dietary habits and declines in cognitive function over three years among Chinese illiterate elderly.

Design and methods

This study was part of the Chinese Longitudinal Health Longevity Study (CLHLS). Six thousand nine hundred and eleven illiterate residents aged 65 or older were investigated. Socio-demographic and dietary habits data were collected at baseline. The cognitive function of illiterate elderly persons was assessed using Chinese revised Mini Mental State Examination (MMSE-r) in 2002 and 2005. Cognitive decline was defined as MMSE-r score dropped to less than 18 at follow-up among those with normal cognitive function (MMSE-r??18 at baseline). Odds ratios (OR) were calculated via logistic regression models.

Results

Five thousand six hundred and ninety one elderly were included in the current analysis. In bivariate analysis, cognitive decline was associated with gender, marital status,financial status, smoking, drinking alcohol, drinking tea, eating fruits, vegetables, legumes, fishes, meat, egg and sugar. Multivariate logistic regression analysis found that always eating vegetable (Adjusted OR: 0.66; 95% confidence intervals, CI: 0.58, 0.75), always consuming legumes (AOR:0.78; 95% CI: 0.64, 0.96) were inversely associated with cognitive decline.

Conclusions

Lower intakes of vegetables and legumes were associated with cognitive decline among illiterate elderly Chinese. Dietary factors may be important for prevention cognitive decline.     

Forty-year coronary mortality trends and changes in major risk factors in the first 10 years of follow-up in the seven countries study

Time trends in coronary heart disease (CHD) mortality during a 40-year follow-up were studied in the Seven Countries Study. Thirteen cohorts of men aged 40–59 at entry were enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece and Japan) for a total of 10,628 subjects. Cardiovascular risk factors were measured at entry and at the 10-year follow-up examination and coronary heart disease mortality data collected during 40 years. During the 40-year follow-up, the hazard rate of the Weibull parametric distribution (annual conditional risk of death) for CHD mortality tended to slightly decline in the US, Finnish, Dutch and Japanese cohorts, moderately increased in Italy and exponentially increased in cohorts of Serbia and Greece. A strong positive association was found between the shape of the hazard curve, describing the acceleration of the hazard, and a score of population mean risk factor changes (serum cholesterol, systolic blood pressure and smoking prevalence) observed during the first 10 years of follow-up, with a correlation coefficient of 0.91 between the two indicators. The countries with a relative decline in the annual hazard function were the same where, during the same historical period, large decreases in official death rate from CHD were recorded, and viceversa. The acceleration in mortality risk for CHD mortality in different countries, described by the shape of the Weibull distribution, is related to changes in mean levels of major coronary risk factors.     

Scoring of prudent dietary habits and its relation to 25-year survival

To evaluate the effect on longevity of a diet that is concurrent with common dietary guidelines, a simple diet scoring system was developed and applied in a follow-up study of 2,820 middle-aged Dutch civil servants and their spouses. In the early 1950s those civil servants were seen for a health examination that included a dietary survey. Consumption frequency data of the quantitatively most important food items at that time were used for the diet scoring. Overall survival after 25 years was 46.8% among men and 68.6% among women. In men, a significant positive association between prudent diet score and 25-year, age-adjusted survival could be demonstrated. Of the 10 food items that constituted the diet score, a higher intake of brown bread, porridge and/or yogurt, vegetables, fish, and fruit was associated with a slightly better survival. In a separate analysis we had found a significant inverse relationship between coffee consumption and survival. A similar trend, which, however, was not significant, was observed for alcohol intake. In women, the results for the separate food items were inconsistent, and no effect of a prudent diet score on longevity was observed. The proposed diet scoring system provides a means for evaluating the effects of the individual's food choice behavior on subsequent health and longevity.     

中国8个长寿地区65岁及以上老年人饲养动物对死亡风险的影响

目的 探讨中国长寿地区65岁及以上老年人饲养动物与全死因死亡风险的关系。 方法 将来自 “老年健康生物标志物队列研究” 10 555名65岁及以上的老年人群纳入研究,2008年基线调查收集对象的人口学特征、生活方式及健康状况等信息,2011—2012年、2014年和2018年随访生存结局和死亡时间。采用Cox比例风险模型分析饲养动物对死亡风险的影响。 结果 10 555名研究对象年龄为(87.24±10.91)岁,其中女性5 914名(56.03%)。10年随访期间共有8 318名死亡,死亡率为78.81%,其中不饲养动物组为83.34%,显著高于偶尔饲养动物组(77.33%)和经常饲养动物组(62.40%)(P<0.001)。调整相关混杂因素后,经常饲养动物组可以降低16.60%的全因死亡率(HR=0.834,95%CI:0.783~0.888)。分层分析的结果显示,与不饲养动物组相比,在80~89岁、90~105岁的老年人群和失能老年人群中,经常饲养动物组的死亡风险下降(HR=0.777,95%CI:0.698~0.864;HR=0.884,95%CI:0.801~0.977;HR=0.642,95%CI:0.480~0.859)。 结论 饲养动物是中国老年人的死亡风险降低的保护因素。     

北京市社区老年人群血压水平与认知功能变化的4年纵向研究

目的 探讨北京市社区老年人血压与通过简短精神状态(MMSE)量表检测的认知功能之间的关系。方法 以北京市一个有代表性的60岁及以上老年群体为研究对象,进行大样本的纵向流行病学研究。于1993年进行基线调查,检测血压,以MMSE为工具检查认知功能,并进行问卷调查,内容包括人口学情况、健康状况、生活状况等。1997年进行随访,以相同的工具复测认知功能并进行问卷调查,分析基线认知功能正常者4年后的变化。结果 2079名基线认知得分正常的老年人,平均收缩压为(141.77±24.94)mmHg(1mmHg=0.133kPa),平均舒张压为(81.76±12.08)mmHg。基线平均MMSE得分(25.65±3.59)分,4年后随访平均MMSE得分(23.24±5.63)分。随访得分与基线得分比较下降≥4分为认知功能明显下降。发现随着基线收缩压及舒张压水平增高,认知得分及认知功能明显下降的老年人比例增大。分层分析提示,在低龄(<75岁)、农村、无糖尿病及不用降压药物的老年人中,不同血压水平对认知功能改变有显著影响,血压水平高者认知得分明显下降的比例增大,这种关系在排除脑血管病和心脏病的影响后,在收缩压组依然存在。结论 纵向研究显示,老年人收缩压及舒张压升高可导致认知功能受损,随着血压水平的增高,认知功能下降的幅度增大。     

中国8个长寿地区65岁及以上老年人视力不良对死亡风险的影响

目的探讨中国长寿地区≥65岁老年人视力不良与全死因死亡风险的关系。方法数据来源于"中国老年健康影响因素跟踪调查"子队列-"老年健康生物标志物队列研究数据库",本研究选取该项目中2012年的≥65岁老年人的身体测量和死亡指标进行分析,2014年和2017年随访生存结局。采用Cox比例风险回归模型分析视力对死亡风险的影响。按年龄和性别分亚组进一步分析数据。结果共纳入1736名老年人,5年随访期间共有943人死亡,5年死亡率为54.3%。视力不良组的5年死亡率为76.7%,高于视力良好组的47.6%(P<0.001)。校正人口学信息、生活方式、部分疾病因素后,视力不良组5年死亡风险是视力良好组的1.30倍(HR=1.30,95%CI:1.09~1.55)。女性老年人群中,视力不良组的死亡风险是视力良好组的1.48倍(HR=1.48,95%CI:1.20~1.84),而男性老年人的视力与死亡风险无关联(HR=1.02,95%CI:0.72~1.43)。在≥90岁的老年人群中,视力不良人群的死亡风险是视力良好组的1.39倍(HR=1.39,95%CI:1.13~1.70)。而65~79岁和80~89岁老年人的视力与死亡风险均无关联(HR=1.37,95%CI:0.61~3.07;HR=0.95,95%CI:0.61~1.48)。结论视力不良是中国老年人的死亡风险升高的危险因素。