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Application of a Joint Multivariate Longitudinal–Survival Analysis to Examine the Terminal Decline Hypothesis in the Swiss Interdisciplinary Longitudinal Study on the Oldest Old

Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.

Address correspondence to Paolo Ghisletta, Faculty of Psychology and Educational Sciences, University of Geneva, 4136 UniMail, Boulevard du Pont d'Arve 40, 1211 Genève 4, Switzerland. E-mail: paolo.ghisletta{at}pse.unige.ch

In this work I aim at extending current knowledge on the terminal decline hypothesis by applying a joint multivariate longitudinal–survival analysis to the cognitive data of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old. (In that study, 529 individuals between 79 and 85 years of age at study inception were assessed up to five times on a task of perceptual speed and one of verbal fluency.) I simultaneously estimated a multivariate, multilevel longitudinal model and a Weibull survival model to test whether individual performance and change in speed and fluency predict survival, controlling for retest effects, initial age, gender, overall health, socioeconomic status, and sensory functioning. Results revealed that age and performance level in fluency predicted survival, whereas level in speed and change in both cognitive variables did not. I discuss the relevance of fluency tasks in predicting mortality.

Key Words: Terminal decline • Change in cognitive performance and survival • Joint multivariate longitudinal-survival mode