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P2‐429: The Impact of Frailty and Cognitive Decline on Quality of Life: How does Social Context Matter?
Author(s) -
Godin Judith,
Armstrong Joshua J.,
Wallace Lindsay,
Rockwood Kenneth,
Andrew Melissa K.
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.1641
Subject(s) - context (archaeology) , vulnerability (computing) , gerontology , quality of life (healthcare) , cognition , cognitive decline , psychology , demography , health and retirement study , medicine , dementia , geography , psychiatry , disease , archaeology , pathology , psychotherapist , computer security , sociology , computer science
status and baseline factors were determined. Results: At the 6year follow-up, 319 participants had normal cognition, 210 had MCI, and 67 had dementia; 163 withdrew from the study and 114 were deceased. When compared to normal cognition at followup, the factor most strongly associated with the poorer cognition outcomes (MCI and dementia) and attrition (withdrawn and deceased) was baseline MCI (Table 1). Older age, slower walking speed, and poorer smelling ability were associated with at least one poorer cognition outcome and attrition. Atrial fibrillation and an apolipoprotein E ε4 allele were uniquely associated with poorer cognition outcomes (MCI and both MCI and dementia, respectively), and being male, depressed or on antidepressants and having lower physical activity were uniquely associated with attrition. All baseline factors significantly associated with MCI or dementia remained so in sensitivity analyses that excluded participants lost to attrition. However, significant associations emerged for additional baseline factors: slower walking speed [odds ratio (95% confidence interval)1⁄41.11 (1.00-1.22), p1⁄40.042] and poorer smelling ability [0.89 (0.79-1.00), p1⁄40.040] for MCI, and diabetes [0.11 (0.01-0.94), p1⁄40.043], hypercholesterolaemia [0.48 (0.24-0.96), p1⁄40.039] and being on antidepressants [3.71 (1.22-11.30), p1⁄40.021] for dementia. Conclusions:MCI, older age, poorer smelling ability, slower walking speed, and an apolipoprotein E ε4 allele all predicted MCI or dementia 6 years later. This has implications for the early identification of individuals most at risk of developing dementia, and the implementation of strategies to minimise future cognitive decline.