Search

Yutaka Takata,1 Toshihiro Ansai,2 Inho Soh,2 Shuji Awano,2 Ikuo Nakamichi,1 Sumio Akifusa,3 Kenichi Goto,1 Akihiro Yoshida,2 Hiroki Fujii,1 Ritsuko Fujisawa,1 Kazuo Sonoki31Division of General Internal Medicine, Kyushu Dental University, 2Division of Community Oral Health Development, Kyushu Dental University, 3Department of Oral Health and Environment, School of Oral Health Science, Kyushu Dental University, Kitakyushu, JapanAbstract: The relationship between mortality and impaired cognitive function has not been thoroughly investigated in a very elderly community-dwelling population, and little is known about the association of disease-specific mortality with Mini-Mental State Examination (MMSE) subscale scores. Here we evaluated these data in Japanese community-dwelling elderly. In 2003, 85 year-olds (n=207) were enrolled; 205 completed the MMSE for cognitive function and were followed-up for 10 years, during which time 120 participants died, 70 survived, and 17 were lost to follow-up. Thirty-eight deaths were due to cardiovascular disease, 22 to senility, 21 to respiratory disease, and 16 to cancer. All-cause mortality decreased by 4.3% with a 1-point increase in the global MMSE score without adjustment, and it decreased by 6.3% with adjustment for both sex and length of education. Cardiovascular mortality decreased by 7.6% and senility mortality decreased by 9.2% with a 1-point increase in the global MMSE score with adjustment for sex and education. No association was found between respiratory diseases or cancer mortality and global MMSE score. All-cause mortality also decreased with increases in MMSE subscale scores for time orientation, place orientation, delayed recall, naming objects, and listening and obeying. Cardiovascular mortality was also associated with the MMSE subscale of naming objects, and senility mortality was associated with the subscales of time orientation and place orientation. Thus, we found that impaired cognitive function determined by g

Yutaka Takata,1 Toshihiro Ansai,2 Inho Soh,2 Shuji Awano,2 Ikuo Nakamichi,1 Sumio Akifusa,3 Kenichi Goto,1 Akihiro Yoshida,2 Hiroki Fujii,1 Ritsuko Fujisawa,1 Kazuo Sonoki3 1Division of General Internal Medicine, 2Division of Community Oral Health Development, 3Department of Oral Health and Environment, School of Oral Health Science, Kyushu Dental College, Kitakyushu, Japan Abstract: Little is known about the association between total cholesterol (TC) and all-cause mortality in the elderly (especially the very elderly). Here we examined the association between TC and all-cause mortality in 207 very elderly (85-year-old) participants. In 2003, we performed a baseline laboratory blood examination, and blood pressure (BP) and body mass index (BMI) measurements, and lifestyle questionnaires were completed by the participants. The participants were followed for the subsequent 10 years. As of 2013, of the 207 participants in 2003, 70 participants had survived, 120 individuals had died, and 17 were lost to follow up. The TC values were divided into high-TC (≥209 mg/dL), intermediate-TC (176–208 mg/dL), and low-TC (≤175 mg/dL) categories. With the Kaplan–Meier method, we found that both the high-TC and intermediate-TC participants survived longer than the low-TC participants. The men with high TC survived longer than those with low TC, but no corresponding difference was found for the women. A multivariate Cox proportional hazards regression model, with adjustment for gender, smoking, alcohol intake, history of stroke or heart disease, serum albumin concentration, BMI, and systolic BP, revealed that the total mortality in the low-TC group was 1.7-fold higher than that in the high-TC group. Mortality, adjusted for the same factors, decreased 0.9% with each 1 mg/dL increase in the serum TC concentration and decreased 0.8% with each 1 mg/dL increase in the serum (low-density lipoprotein) LDL-cholesterol (LDL-C) concentration. Our results indic

Yutaka Takata,1 Toshihiro Ansai,2 Inho Soh,2 Shuji Awano,2 Ikuo Nakamichi,1 Sumio Akifusa,3 Kenichi Goto,1 Akihiro Yoshida,2 Hiroki Fujii,1 Ritsuko Fujisawa,1 Kazuo Sonoki31Division of General Internal Medicine, 2Division of Community Oral Health Science, 3Department of Oral Health and Environment, School of Oral Health Science, Kyushu Dental University, Kitakyushu, JapanBackground: Little is known about the relationship between disease-specific mortality and high-level activities of daily living in the elderly. We examined whether mortality is associated with high-level activities of daily living in an octogenarian population.Methods: We conducted a population-based cross-sectional and prospective cohort study in 693 older persons aged 80 years and living in Japan’s Fukuoka Prefecture. We then evaluated the association between 12-year disease-specific mortality and high-level functional capacity as measured by the Tokyo Metropolitan Institute of Gerontology Index of Competence, which is a standardized multidimensional 13-item instrument; items 1 through 5 are classified as instrumental self-maintenance activity, items 6 through 9 as intellectual activity, items 10 through 13 as social roles activity, and all 13 items together yield total functional capacity.Results: By the 12-year follow-up of the 693 participants, 413 had died, 242 survived, and 38 were unable to be located. Of the 413 who died, 105 died of cardiovascular disease, 73 of respiratory tract disease, 71 of cancer, and 39 of senility. Of the other 125 deaths, 59 were due to other diseases, and the cause of death for 66 participants is not known. The hazard ratio (HR) for all-cause mortality, adjusted for confounding factors with multivariate Cox analyses, fell by 6% (HR 0.937, 95% confidence interval [CI] 0.899–0.978, P = 0.003) with each one-point increase in participants’ scores on the Tokyo Metropolitan Institute of Gerontology Index of total functional capacity. With o