Visuospatial Reasoning Trajectories and Death in a Study of the Oldest Old: A Formal Evaluation of Their Association.
OBJECTIVES
To model trajectories of visuospatial reasoning measured using Kohs Block Design test under realistic missing data assumptions and evaluate their association with hazard of death.


METHODS
A joint longitudinal-survival model was used to estimate trajectories of visuospatial reasoning under a missing not at random assumption of participants from the Origins of Variance in the Old-Old: Octogenarian Twins study. Sensitivity analyses to missing data assumptions were conducted.


RESULTS
Visuospatial reasoning declined at constant rate. Baseline age, dementia status, education, and history of stroke were associated with visuospatial reasoning performance, but only dementia was associated with its rate of decline. Importantly, our results demonstrated an association between poorer visuospatial reasoning and increased hazard of death. Baseline age and sex were associated with risk of death.


DISCUSSION
We confirmed an association between visuospatial reasoning and death under plausible missing data assumptions.
['Muniz-Terrera|Graciela|G|', 'Massa|Fernando|F|', 'Benaglia|Tatiana|T|', 'Johansson|Boo|B|', 'Piccinin|Andrea|A|', 'Robitaille|Annie|A|']
D000369:Aged, 80 and over D000375:Aging D003704:Dementia D005260:Female D006801:Humans D008137:Longitudinal Studies D008297:Male D009026:Mortality D009483:Neuropsychological Tests D016016:Proportional Hazards Models D065855:Spatial Processing
joint longitudinal-survival missing not at random cognitive decline