P2‐519: “DUAL DECLINE” IN OLDER ADULTS AND RISK FOR MORTALITY: RESULTS FROM THE HEALTH ABC STUDY

Abstract

Good cognitive and physical function are central to living a long and purposeful life. With increasing age, adults often experience cognitive decline and mobility impairments. Declines in either are associated with increased mortality. However, they are typically studied as independent entities. Few longitudinal studies have specifically examined “dual decline”: the concomitant decline in physical and cognitive function and its association to mortality. Utilizing data from the Health, Aging, and Body Composition Study (Health ABC), we included 2,253 adults age 70–79 at baseline and calculated four mutually exclusive trajectories of decline (no decline (n= 1190), cognitive decline (n=445), physical decline (n=407), and dual decline (n=211)) based on repeated measures of cognition (Modified Mini-Mental State Exam: (3MS)) and physical function (Short Physical Performance Battery (SPPB)) across 5 years. These categories were then prospectively used to examine time to death over the subsequent 10 years. Results from Cox regression models adjusted for age, sex, education, BMI, site, smoking, diabetes, and hypertension showed that cognitive decline (Hazard Ratio (HR): 1.45 [95% Confidence Interval [1.24-1.69]) and physical decline (HR: 1.57 [1.34-1.83]) were significantly associated with mortality compared to the control group (no decline). Dual decline was associated with nearly a 2-fold higher risk (HR: 2.48 [2.05-2.99]) compared to the control group. Compared to the no decline group, the median survival times for cognitive and physical decline were 1.3 and 1.6 years shorter, respectively, while the dual decline group was 4.3 years shorter. Future studies examining cognitive decline OR physical decline should include individuals with dual decline as this group may represent an especially vulnerable population. Risk factors for each type of decline are being investigated and may offer insights into the mechanisms underlying dual decline. Declines in the last decade of life may be modifiable and future studies should focus on preserving both physical and cognitive function in older adults.