Mini-Mental State Examination as a Predictor of Mortality among Older People Referred to Secondary Mental Healthcare

TY - JOUR

T1 - Mini-Mental State Examination as a Predictor of Mortality among Older People Referred to Secondary Mental Healthcare

AU - Su, Yu-Ping

AU - Chang, Chin-Kuo

AU - Hayes, Richard D.

AU - Perera, Gayan

AU - Broadbent, Matthew

AU - To, David

AU - Hotopf, Matthew

AU - Stewart, Robert

PY - 2014/9/3

Y1 - 2014/9/3

N2 - Background: Lower levels of cognitive function have been found to be associated with higher mortality in older people, particularly in dementia, but the association in people with other mental disorders is still inconclusive.Methods and Findings: Data were analysed from a large mental health case register serving a geographic catchment of 1.23 million residents, and associations were investigated between cognitive function measured by the Mini-Mental State Examination (MMSE) and survival in patients aged 65 years old and over. Cox regressions were carried out, adjusting for age, gender, psychiatric diagnosis, ethnicity, marital status, and area-level socioeconomic index. A total of 6,704 subjects were involved, including 3,368 of them having a dementia diagnosis and 3,336 of them with depression or other diagnoses. Descriptive outcomes by Kaplan-Meier curves showed significant differences between those with normal and impaired cognitive function (MMSE scoreConclusion: Current study identified an association between cognitive impairment and increased mortality in older people using secondary mental health services regardless of a dementia diagnosis. Causal pathways between this exposure and outcome (for example, suboptimal healthcare) need further investigation.

AB - Background: Lower levels of cognitive function have been found to be associated with higher mortality in older people, particularly in dementia, but the association in people with other mental disorders is still inconclusive.Methods and Findings: Data were analysed from a large mental health case register serving a geographic catchment of 1.23 million residents, and associations were investigated between cognitive function measured by the Mini-Mental State Examination (MMSE) and survival in patients aged 65 years old and over. Cox regressions were carried out, adjusting for age, gender, psychiatric diagnosis, ethnicity, marital status, and area-level socioeconomic index. A total of 6,704 subjects were involved, including 3,368 of them having a dementia diagnosis and 3,336 of them with depression or other diagnoses. Descriptive outcomes by Kaplan-Meier curves showed significant differences between those with normal and impaired cognitive function (MMSE scoreConclusion: Current study identified an association between cognitive impairment and increased mortality in older people using secondary mental health services regardless of a dementia diagnosis. Causal pathways between this exposure and outcome (for example, suboptimal healthcare) need further investigation.

KW - ALL-CAUSE MORTALITY

KW - BRC CASE REGISTER

KW - COGNITIVE IMPAIRMENT

KW - ALZHEIMERS-DISEASE

KW - EXCESS MORTALITY

KW - SOUTH LONDON

KW - FOLLOW-UP

KW - SURVIVAL

KW - DEPRESSION

KW - DEMENTIA

U2 - 10.1371/journal.pone.0105312

DO - 10.1371/journal.pone.0105312

M3 - Article

SN - 1932-6203

VL - 9

JO - PL o S One

JF - PL o S One

IS - 9

M1 - e105312

ER -