ArticleEnvironmental health and preventive medicine2026
Cognitive function predicts all-cause mortality independent of social engagement among community-dwelling elderly Japanese men: a 15-year prospective cohort study.
Article in Environmental health and preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAs the global population ages, cognitive impairment has become a growing public health concern. Although epidemiological studies have examined its association with mortality, sex-stratified analyses and community-based investigations in elderly Asian men remain scarce. Furthermore, social engagement may confound the association between cognitive impairment and mortality; yet few studies among community-dwelling elderly Asian men have simultaneously examined cognitive impairment and social engagement in relation to all-cause mortality in a prospective cohort design. This study therefore aimed to examine whether cognitive impairment is associated with an increased risk of all-cause mortality independent of social engagement among community-dwelling elderly Japanese men over a 15-year follow-up period.
methodsThis prospective cohort study enrolled 2,174 men aged ≥65 years. Follow-up assessments were conducted at five, ten, and fifteen years, with all-cause mortality as the primary outcome. Cognitive function was assessed using the Mini-Mental State Examination. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to examine the association between cognitive function and all-cause mortality. Confounder-adjusted Kaplan-Meier survival curves were generated using inverse probability of treatment weighting.
resultsThe final analytic sample comprised 1,741 men. High social engagement was associated with a lower risk of all-cause mortality. Compared with participants with normal cognitive function, the hazard ratios (HRs) for all-cause mortality were 1.29 (95% CI: 1.06-1.56) for mild cognitive impairment and 1.59 (95% CI: 1.10-2.29) for severe cognitive impairment, after adjusting for potential confounding factors including social engagement.
conclusionsCognitive impairment independently predicts an increased risk of all-cause mortality in community-dwelling elderly Japanese men.
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