Abstract
BackgroundDisturbed cognitive function is associated with several causes of mortality; however, the association between cognitive function and the risk of cancer death has not been extensively investigated yet. We aimed to evaluate the association of cognitive function with the risk of cancer death and all-cause mortality in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) and Leiden 85-plus Study. Additionally, a systematic review and meta-analysis of longitudinal studies were conducted to evaluate the association of cognitive function and risk of cancer death.MethodsRisk of cancer death and all-cause mortality were reported using hazard ratios (HRs) with 95% confidence interval (CI) in tertiles of cognitive function of PROSPER and Leiden85-Plus Study. Additionally, PubMed, Embase, Web of Science, Cochrane, PsycINFO, Academic Search Premier, CINHAL, and Emcare were searched up to November 1st, 2020 to perform a systematic review and meta-analysis. The relative risks (RRs) with 95%CI of cancer death per each standard deviation lower performance in cognitive measurements were calculated.ResultsParticipants of PROSPER had 1.65-fold (95%CI 1.11–2.47) greater risk of cancer death (P for trend = 0.016) and 1.85-fold (95%CI 1.46–2.34) higher risk of all-cause mortality (P for trend<0.001), in multivariable models. Results of the Leiden-85 Plus Study showed that subjects with MMSE score below 24 had a lower chance of cancer death (HR 0.79, 95%CI 0.36–1.70, P for trend = 0.820) but had 2.18-fold (95%CI 1.57–3.02) higher risk of all-cause mortality compared to the reference group (P for trend<0.001). Besides, the results of systematic review and meta-analysis showed that per each standard deviation lower performance in cognitive function, individuals were at a 10% higher chance of cancer death (RR 1.10, 95%CI 1.00–1.20, P-value = 0.044).ConclusionsLower cognitive function performance is associated with a marginally increased risk of cancer death, in line with a significantly greater risk of all-cause mortality.
Highlights
Research indicated that older individuals with covert or overt vascular injuries might be at increased risk of cancer development and mortality because of shared risk factors and common pathogenesis [1]
Longitudinal studies have stated that impaired cognitive function and different types of dementia are associated with higher risk of cardiovascular and all-cause mortality in older subjects, independent of confounders including socioeconomic status, history of vascular disease, and cardiovascular risk factors [9,10,11,12]
We aimed to evaluate the association of cognitive function with the risk of cancer death and all-cause mortality in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) and the Leiden 85-plus Study
Summary
Research indicated that older individuals with covert or overt vascular injuries might be at increased risk of cancer development and mortality because of shared risk factors and common pathogenesis [1]. Longitudinal studies have stated that impaired cognitive function and different types of dementia are associated with higher risk of cardiovascular and all-cause mortality in older subjects, independent of confounders including socioeconomic status, history of vascular disease, and cardiovascular risk factors [9,10,11,12]. The link between lower cognitive function with cardiovascular and all-cause mortality has been studied previously [16,17,18], only a few longitudinal studies have investigated whether cognitive function measured before cancer diagnosis might be associated with the risk of death due to cancer, among middle-aged and older individuals [17,18,19,20,21]. A systematic review and meta-analysis of longitudinal studies were conducted to evaluate the association of cognitive function and risk of cancer death
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