Gender-specific impact of cognitive impairment on all-cause mortality in older persons: A meta-analysis

Background: Gender-specific impact of cognitive impairment on survival in the general population remains controversial. The objective of this meta-analysis was to assess the gender difference in the impact of cognitive impairment on all-cause mortality in the general population. Methods: Two reviewers independently searched PubMed and Embase databases up to September 30, 2021 for cohort studies that reported gender-specific impact of cognitive impairment detected by the mini-mental state examination (MMSE) on all-cause mortality in elderly general population (aged =60 years) in the same study. Results: Nine articles reporting on 10 studies with a total of 52,134 individuals were included. The pooled multivariate-adjusted risk ratio (RR) of all-cause mortality associated with cognitive impairment compared with those without was 1.48 (95% confidence interval [CI] 1.36-1.61) in women and 1.34 (95% CI 1.24-1.44) in men, after adjusting for potential confounding. The pooled multivariate-adjusted female-to-male ratio of relative risk of all-cause mortality was 1.08 (95% CI 1.02-1.14) for individuals with cognitive impairment versus those without. Conclusions: Cognitive impairment detected by the MMSE is associated with an increased risk of all-cause mortality in older aged women than in men from the general population, even after adjusting sociodemographic factors. Compared with men with cognitive impairment, women with cognitive impairment had an 8% higher risk of all-cause mortality. These findings highlight the importance of early detection and management of cognitive impairment in older adults, particularly in women.