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Cognition and survival: an exploration in a large multicentre study of the population aged 65 years and over
Neale R, Brayne C, Johnson AL, Medical Research Council Cognitive Function and Ageing Study Writting Committee.. International journal of epidemiology, 2001-12-01
Topic: Risk, prevention and care in population studies
Background Understanding the patterns in determinants of survival becomes increasingly important as the population ages. Dementia is known to shorten survival as is impaired cognition. Whether this is a continuous phenomenon and independent of other explanatory variables is less clear. Objectives To examine a population-based dataset in which a measure of cognitive function (Mini-Mental State Examination [MMSE]), self-reported physical health and lifestyle variables were measured at outset, with monitoring for mortality thereafter. Methods The five identical sites of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) were analysed, with populations in rural Cambridgeshire, Gwynedd, Newcastle, Nottingham and Oxford. Survival curves were modelled and stratified analyses carried out, with physical disease, sociodemographic variables and lifestyle variables as covariates. Results There was a strong and consistent reduction in survival probability for each decrement in MMSE. Adjustment for known confounders did not alter this pattern. Social class and education in particular had no additional effect. Self-reported health was the only other associated variable. Conclusion Cognitive function appears to be a marker of capacity for survival in the UK. Terminal decline can account for some of this. Actuarial survival provided here can give carers and service providers an idea of prognosis at given ages and levels of cognition, and provide baseline data for those planning interventions in similar groups.
Key findings
- Results There was a strong and consistent reduction in survival probability for each decrement in MMSE.
Why it matters
In this large multicentre UK study, each lower score on the Mini-Mental State Examination was linked to a strong and consistent reduction in survival, and adjustment for other factors did not change this pattern. It describes cognitive function as a marker of survival and does not test a treatment, cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International journal of epidemiology) |
| Journal's citation record | 3 / 4 | International Journal of Epidemiology: journal h-index 328 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2001 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 119 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.4 citations a year over 27 year(s) since 2001 |
| Impact for its field and year | 2 / 6 | Cited 2.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author A. L. Johnson: h-index 17 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | QIMR Berghofer Medical Research Institute: institution h-index 737 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11821351) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 40 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Neale, R., Brayne, C., Johnson, A. L., & Medical Research Council Cognitive Function and Ageing Study Writting Committee. (2001). Cognition and survival: an exploration in a large multicentre study of the population aged 65 years and over. International journal of epidemiology. https://doi.org/10.1093/ije/30.6.1383
Vancouver
Neale R, Brayne C, Johnson AL, Medical Research Council Cognitive Function and Ageing Study Writting Committee. Cognition and survival: an exploration in a large multicentre study of the population aged 65 years and over. International journal of epidemiology. 2001. doi:10.1093/ije/30.6.1383. PMID: 11821351.
BibTeX
@article{neale2001-11821351,
author = {Neale, R. and Brayne, C. and Johnson, A. L. and {Medical Research Council Cognitive Function and Ageing Study Writting Committee}},
title = {{Cognition and survival: an exploration in a large multicentre study of the population aged 65 years and over}},
journal = {International journal of epidemiology},
year = {2001},
doi = {10.1093/ije/30.6.1383},
pmid = {11821351},
url = {https://doi.org/10.1093/ije/30.6.1383}
}
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