Operationalisation of Amnestic Mild Cognitive Impairment in the Medical Research Council Cognitive Function and Ageing Study SD, standard deviation

<p>Operationalisation of Amnestic Mild Cognitive Impairment in the Medical Research Council Cognitive Function and Ageing Study SD, standard deviation</p

Schematic Overview of the Approach Used to Classify MCI across Different Definitions in the Medical Research Council Cognitive Function and Ageing Study

<p>AACD, age-associated cognitive decline; AAMI, age-associated memory impairment; ACMI, age-consistent memory impairment; ARCD, age-related cognitive decline; CIND, cognitive impairment no dementia; DEM, dementia; LCD, limited cognitive disturbance; MCD (ICD-10), mild cognitive disorder (International Classification of Diseases 10th Revision); MCD_i (GDS3), mild cognitive decline (Global Deterioration Scale Stage 3); MCD_o(GDS4), moderate cognitive decline (Global Deterioration Scale Stage 4); MD, minimal dementia; M-MCI, multiple mild cognitive impairment; MMSE, Mini Mental State Examination Cut-off Scores; MNCD, mild neurocognitive disorder; N-MCI, non-amnestic mild cognitive impairment; QD, questionable dementia; SD, standard deviation; SMC, self-reported memory complaint.</p

Prevalence of ‘Difficulty’ in (I)ADL and Mobility Items - %(n).

<p>*Statistically significant gender difference at α = 0.05.</p>§<p>- Odds ratio: Women: Men.</p

Relative Difficulty of BADL, IADL and Mobility Items (Domain of Disability [<b>5</b>]).

<p>Abbreviations: BADL – Basic Activities of Daily Living. IADL – Instrumental Activities of Daily Living.</p

Hierarchy of Loss of Ability in (I/B)ADL and Mobility Items Formed by Mokken Scaling.

<p>*Violated double monotonicity assumption (when cognition items were included).</p

Association of the Hierarchical Disability Scale with Known Predictors of Disability - %(n).

<p>Association of the Hierarchical Disability Scale with Known Predictors of Disability - %(n).</p

The Contribution of Diseases to the Male-Female Disability-Survival Paradox in the Very Old: Results from the Newcastle 85+ Study

<div><p>Background</p><p>Explanations for the male-female disability-survival paradox - that woman live longer than men but with more disability - include sex differences in diseases and their impact on disability and death. Less is known about the paradox in the very old. We examine sex differences in the presence and impact of disabling and fatal diseases accounting for the male-female disability-survival paradox in very late life.</p><p>Methods</p><p>We use data from the Newcastle 85+ Study, a cohort of people born in 1921 and all recruited at age 85 in 2006. Participants underwent a health assessment (HA) at baseline, 18 months, 36 months, 60 months, and a review of their GP records (GPRR) at baseline and 36 months. We used multi-state modelling to assess the impact of specific diseases on disability and death. Disability (measured via ADLs/IADLs) was categorised as no disability (difficulty with 0 activities), or disabled (difficulty with one or more activities). Diseases were ascertained from review of general practice records and cognitive impairment which was defined as an sMMSE of 21 or less (from health assessment).</p><p>Results</p><p>In participants who had complete HA and GPRR, women had more arthritis (RR = 1.2, 95% CI: 1.1–1.3) and hypertension (RR = 1.2, 95%CI 1.0–1.3), more disability, and were more likely disabled at all follow-ups. From multistate models, women with cerebrovascular disease (HR: 2.6, 95% CI: 2.1–3.4) or respiratory disease (HR: 2.0, 95% CI: 1.4–3.0) were more likely to become disabled than those without but this did not hold for men (sex difference p<0.01). Men were more likely to die from respiratory disease (HR: 2.2, 95% CI: 1.8–2.8) but this did not hold for women (p = 0.002).</p><p>Conclusion</p><p>The disability-survival paradox was still evident at age 85 and appears due to sex differences in the types of diseases and their impact on the disability pathway.</p></div

Mean sojourn times in state (years) by disease group.

<p>Mean sojourn times in state (years) by disease group.</p

Transition probabilties for two diseases by gender.

<p>Transition probabilties for two diseases by gender.</p

Conditions examined with data sources and ascertainement criteria.

<p>Conditions examined with data sources and ascertainement criteria.</p