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Individual and Combined Associations of Cognitive and Mobility Limitations on Mortality Risk in Older Adults
Authors:Emily Frith  Ovuokerie Addoh  Joshua R Mann  B Gwen Windham  Paul D Loprinzi
Institution:1. Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, Jackson;2. Department of Preventive Medicine, University of Mississippi Medical Center, Jackson;3. Department of Medicine, Division of Geriatrics, Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson;4. Jackson Heart Study Vanguard Center of Oxford, Jackson; and the Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University
Abstract:

Objective

To evaluate the potential independent and combined associations of cognitive and mobility limitations on risk of all-cause mortality in a representative sample of the US older adult population who, at baseline, were free of cardiovascular and cerebrovascular disease.

Patients and Methods

Data from the 1999 to 2002 National Health and Nutrition Examination Survey were used to identify 1852 adults (age, 60-85 years) with and without mobility and/or cognitive limitations. Hazard ratios (HRs) for mortality risk were calculated for 4 mutually exclusive groups: no limitation (group 1 as reference), mobility limitation only (group 2), cognitive limitation only (group 3), both cognitive and mobility limitations (group 4).

Results

Compared with group 1, the adjusted HRs (95% CI) for groups 2, 3, and 4 were 1.72 (1.24-2.38), 2.00 (1.37-2.91), and 2.18 (1.57-3.02), respectively. The mortality risk when comparing group 4 (HR, 2.18) with group 3 (HR, 2.00), however, was not statistically significant (P=.65). Similarly, the mortality risk when comparing group 4 (HR, 2.18) with group 2 (HR, 1.72) was not statistically significant (P=.16).

Conclusion

Although the highest mortality risk occurred in those with both limitations (group 4), this point estimate was not statistically significantly different when compared with those with cognitive or mobility limitations alone.
Keywords:DSST  Digit Symbol Substitution Test  HR  hazard ratio  MET  metabolic equivalent of task  NHANES  National Health and Nutrition Examination Survey
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