The Influence of Multimorbidity on Leading Causes of Death in Older Adults With Cognitive Impairment

Nicholas K. Schiltz, David F. Warner, Jiayang Sun, Kathleen A. Smyth, Stefan Gravenstein, Kurt C. Stange, Siran M. Koroukian

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objective: The aim of this study is to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. Method: This is a population-based study using data from the linked 1992-2010 Health and Retirement Study and National Death Index (n = 9,691). Multimorbidity is defined as a combination of chronic conditions, functional limitations, and geriatric syndromes. Regression trees and Random Forest identified which combinations of multimorbidity associated with causes of death. Results: Multimorbidity is common in the study population. Heart disease is the leading cause in all groups, but with a larger percentage of deaths in the mild and moderate/severe cognitively impaired groups than among the noncognitively impaired. The different “paths” down the regression trees show that the distribution of causes of death changes with different combinations of multimorbidity. Discussion: Understanding the considerable heterogeneity in chronic conditions, functional limitations, geriatric syndromes, and causes of death among people with cognitive impairment can target care management and resource allocation.

Original languageEnglish (US)
Pages (from-to)1025-1042
Number of pages18
JournalJournal of Aging and Health
Issue number6
StatePublished - Jul 1 2019


  • cause of death
  • cognitive status
  • comorbidity
  • mortality

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies


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