Does cognitive ability predict mortality in the ninth decade? The Lothian Birth Cohort 1921

To test whether cognitive ability predicts survival from age 79 to 89 years data were collected from 543 (230 male) participants who entered the study at a mean age of 79.1 years. Most had taken the Moray House Test of general intelligence (MHT) when aged 11 and 79 years from which, in addition to intelligence measures at these two time points, relative lifetime cognitive change was calculated. Cognitive domain measures at age 79 included: vocabulary, nonverbal reasoning, verbal declarative memory, and executive functioning. A fluid-type general intelligence component (gf) was extracted from reasoning, memory, and executive functioning. Socio-demographic, health behaviour, and health status measures were included as covariates in Cox's proportional hazard regression models of the cognition–mortality associations. Having attained the age of 79, gf, reasoning and memory measured in later-life, and the relative change in cognitive ability (11 to 79 years) are important in predicting mortality. Health and socio-demographic status are possible mechanisms through which cognitive ability predicts mortality in old age.

► Amongst epidemiologists the cognition-mortality association is well recognised. ► Measuring general and specific cognitive ability in youth and old age is important. ► Memory and cognitive change were major predictors of mortality in the ninth decade. ► Childhood cognitive ability did not predict survival between 79 and 89 years.