{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:39:57Z","timestamp":1790815197555,"version":"4.1.0"},"reference-count":48,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Schizophrenia is associated with premature mortality from mostly natural causes. Decreased cognitive functioning has been identified as a determinant of mortality in the general population. However, there have been few prospective studies of this issue in persons with schizophrenia.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine whether lower cognitive functioning is a risk factor for natural cause mortality in schizophrenia.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This prospective cohort study included persons with schizophrenia or schizoaffective disorder enrolled between February 1, 1999, and December 31, 2022, at a nonprofit psychiatric system in Baltimore, Maryland. Participants were evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and other clinical measures.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Natural cause mortality.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Associations of cognitive function, obesity, tobacco smoking, and medical conditions with natural cause mortality were evaluated using Cox proportional hazards regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 844 participants enrolled (mean [SD] age, 39.6 [12.1] years; 533 male [63.2%]), 158 (18.7%) died of natural causes during a median follow-up of 14.4 years (range, 7.0 days to 23.9 years). The most significant factor associated with mortality was lower cognitive functioning as measured by the RBANS (Cox coefficient, \u22120.04; 95% CI, \u22120.05 to \u22120.03;\n z<\/jats:italic>\n \u2009=\u2009\u22125.72; adjusted\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Additional factors independently associated with mortality included the diagnosis of an autoimmune disorder (hazard ratio [HR], 2.86; 95% CI, 1.83-4.47;\n z<\/jats:italic>\n \u2009=\u20094.62; adjusted\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), tobacco smoking (HR, 2.26; 95% CI, 1.55-3.30;\n z<\/jats:italic>\n \u2009=\u20094.23; adjusted\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), diagnosis of chronic obstructive pulmonary disease (HR, 3.31; 95% CI, 1.69-6.49;\n z<\/jats:italic>\n \u2009=\u20093.48; adjusted\n P<\/jats:italic>\n \u2009=\u2009.006), body mass index as a continuous variable (HR, 1.06; 95% CI, 1.02-1.09;\n z<\/jats:italic>\n \u2009=\u20093.30; adjusted\n P<\/jats:italic>\n \u2009=\u2009.01), diagnosis of a cardiac rhythm disorder (HR, 2.56; 95% CI, 1.40-4.69;\n z<\/jats:italic>\n \u2009=\u20093.06; adjusted\n P<\/jats:italic>\n \u2009=\u2009.02), and being divorced or separated (HR, 1.80; 95% CI, 1.22-2.65;\n z<\/jats:italic>\n \u2009=\u20092.97; adjusted\n P<\/jats:italic>\n \u2009=\u2009.02). An RBANS score below the 50th percentile displayed a joint association with being a smoker, having an elevated body mass index, and having a diagnosis of an autoimmune or a cardiac rhythm disorder.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this prospective cohort study, lower cognitive functioning was a risk factor for natural cause mortality in schizophrenia. Efforts should be directed at methods to improve cognitive functioning, particularly among individuals with additional risk factors.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.32401","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T11:01:15Z","timestamp":1725966075000},"page":"e2432401","source":"Crossref","is-referenced-by-count":22,"title":["Risk Factors for Natural Cause Mortality in Schizophrenia"],"prefix":"10.1001","volume":"7","author":[{"given":"Faith","family":"Dickerson","sequence":"first","affiliation":[{"name":"Stanley Research Program, Sheppard Pratt, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabahat","family":"Khan","sequence":"additional","affiliation":[{"name":"Stanley Research Program, Sheppard Pratt, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Origoni","sequence":"additional","affiliation":[{"name":"Stanley 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