{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T23:20:15Z","timestamp":1783552815191,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"am","delay-in-days":366,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T00:00:00Z","timestamp":1574121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009028","name":"Research Institute of Science and Technology for Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Cognitive decline increases mortality risk through dementia\u2010related pathways and might be associated with increased healthcare costs. Using up to 12\u2009years of repeated measures data, we identified trajectories in cognitive function among community\u2010dwelling older Japanese adults. We then examined whether these trajectories were associated with all\u2010cause and cause\u2010specific mortality, and differences in healthcare costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1736 adults aged \u226565\u2009years who were free of disabling dementia completed annual assessments during 2002\u20132014. Cognitive function was assessed with the Mini\u2010Mental State Examination. The average number of follow\u2010up assessments was 3.9, and the total number of observations was 6824 during the follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified five trajectory patterns in cognitive function (high, second, third, fourth, and low) during the 12\u2010year follow\u2010up period. The low (2.0%) and fourth (2.2%) trajectory groups had higher hazard ratios for cardiovascular disease mortality, and hazard ratios for other cause mortality were significantly higher for the third (16.8%) and second (38.8%) trajectory groups than for the high trajectory group (40.3%). Until 5\u2009years of follow up, participants in the two lower\u2010trajectory groups had higher mean combined monthly medical and long\u2010term care costs. After 8\u2009years of follow up, mean costs were highest for the third trajectory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of death from cardiovascular disease was higher in the two lower\u2010trajectory groups in cognitive function, and they showed higher healthcare costs during the first 5\u2009years of follow up. After 8\u2009years of follow up, the third trajectory had the highest healthcare costs, perhaps because of hospitalizations attributable to gradual cognitive decline. <jats:bold>Geriatr Gerontol Int 2019; 19: 1236\u20131242<\/jats:bold>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.13802","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T01:15:13Z","timestamp":1574212513000},"page":"1236-1242","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Association of trajectories of cognitive function with cause\u2010specific mortality and medical and long\u2010term care costs"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2442-2406","authenticated-orcid":false,"given":"Yu","family":"Taniguchi","sequence":"first","affiliation":[{"name":"Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology  Tokyo 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