Background The association between cognitive impairment and cardiovascular disease mortality among older US adults remains incompletely characterized, as prior studies used heterogeneous cohorts. Elucidating this relationship in seniors could inform screening and preventive strategies. We focused on adults aged 60 years or older. Methods In this prospective cohort, 2,569 participants from NHANES 2011–2014 underwent three cognitive tests covering memory, executive function and processing speed. Because no single operational standard for cognitive impairment is universally accepted, we applied two definitions, labeled "cognitive impairment" and "cognitive decline", to test robustness. Mortality through Dec 31, 2019 was ascertained via linkage to the National Death Index. Weighted Cox proportional hazards models, accounting for NHANES sample weights and adjusting for demographic, lifestyle and clinical covariates, estimated adjusted hazard ratios for all-cause and CVD mortality associated with each cognitive classification. Results At baseline, 53.4% met criteria for impairment and 44.4% for decline. During follow-up 19.3% died from any cause and 5.4% from cardiovascular causes. Compared with participants without cognitive impairment, adjusted HRs for CVD and all-cause mortality were 1.97 (95% CI 1.08-3.61; p = 0.028) and 1.47 (95% CI 1.08-2.01; p =0.014). Participants classified with cognitive decline showed similar elevated risks: HR 2.05 (95% CI 1.31-3.21; p = 0.002) for CVD mortality and HR 1.55 (95% CI 1.16-2.06; p = 0.003) for all-cause mortality. Conclusions Cognitive deficits are common in older Americans and independently predict increased cardiovascular and overall mortality, underscoring the need for improved detection and prevention.
Su et al. (Fri,) studied this question.