Abstract 3659: Prognostic Simple Test of Short Memory and Physical Function in Aged 80 and Older Outpatients
Background: Cognitive and physical dysfunction is reported increase mortality in very elderly patients. We evaluated the impact of cognitive and physical dysfunction on future total and cardiovascular death, using simple test of cognitive and physical dysfunction.
Methods: We recruited 523 very elderly outpatients aged ≥80 years (mean±SD age: 84±5.3 years) who had apparently preserved activity of daily living at the baseline, in multicenter prospective study. As evaluation of concealed cognitive and physical dysfunction, we performed a short memory test using visual working memory and the Up and Go test. They were followed up for an average duration of 34 moths (range: 3 to 70 months) and the total and cardiovascular mortalities were evaluated.
Results: Seventy-five deaths including 35 cardiovascular deaths occurred during this follow-up period. Clinic blood pressure levels, diabetes, hyperlipidemia, and smoking were not associated with total and cardiovascular mortalities. Subjects with the lowest cognition sore had higher percentage of total mortality (130 events per 1000 person-years [/1000py] vs. 37 events/1000py) and cardiovascular mortality (72 events/1000py vs. 13 events/1000py) than those with the highest of cognition score. The top quartiles of the Up and Go test was higher in the prevalence of total (130 events/1000py vs. 40 events/1000py) and cardiovascular mortality (43 events/1000py vs. 14 events/1000py) than any other groups. In a Cox regression analysis model controlling for age, male, body mass index and past history of cardiovascular diseases, cognitive and physical dysfunction were independent risk factors for total mortality (Hazard ratio [HR] of the lowest cognitive score=5.01, p=0.001, HR of the top quartiles in the Up and Go test=1.98, p=0.04) and of cardiovascular mortality (HR of the lowest cognitive score=6.53, p=0.003, HR of the top quartiles in the Up and Go test 2.50, p=0.04).
Conclusion: Decreased cognitive function and physical activity evaluated by simple test could be the better predictors of total and cardiovascular mortalities than conventional cardiovascular risk factors including blood pressure levels among Japanese very elderly subjects aged 80 years or more.