Abstract

Introduction: Multiple studies demonstrated an independent and inverse association between cognitive function and mortality but little is known about the cause of death. Hypothesis: We hypothesized that lower cognitive function is related to higher mortality risk and this association is stronger for cardiovascular related deaths. Methods: We included 5569 persons (mean[SE] age 71[0.05], 52% women), from the Third National Health and Nutrition Examination Survey (NHANES III) with available cognitive function measurements and mortality follow-up. Cognitive domains include orientation, attention, immediate and delayed memory as well as global cognition. We used weighted Cox proportional regression models adjusted for age, sex, education, systolic and diastolic blood pressure, body mass index, smoking, history of diabetes and cardiovascular disorders. Results: During an average follow-up of 12 years, 1887 participants died from cardiovascular causes and 2675 died from non-cardiovascular causes. Each SD lower global cognitive performance (SD=6) was related to a 1.11 (95% CI: 1.05, 1.17) higher hazard of all-cause mortality. The associations were more prominent with cardiovascular mortality than with non- cardiovascular mortality (Table). Conclusion: Cognitive impairment in the absence of manifest dementia is an important independent predictor of mortality, in particular from cardiovascular causes.

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