Figure 1

Flow diagram showing the sample. The CSHA assembled a representative cohort of 10,263 participants aged 65 years and older in 1991/1992 (CSHA-1) in all Canadian provinces, with follow-ups occurring in 1996/1997 (CSHA-2) and 2001/2002 (CSHA-3) [CSHA 2000]. At baseline, community-dwelling older adults were screened, and self-reported health evaluation data were available in 8,940 participants who completed the baseline survey. Global cognitive assessment was made with use of the 100-point Modified Mini-Mental State Examination (3MS) [Teng EL, Chui HC. The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry 1987, 48; 314 - 318.]. People who had 3MS total scores ≤;78 were invited to have a detailed clinical cognitive examination, at which time, a clinical diagnosis was made. Cognitive status of all participants was assessed at baseline and at both 5-year and 10-year follow-ups. Subjects who were assessed as cognitively intact at baseline, based on negative screening (3MS >78) and/or a negative clinical diagnosis (2,902 men and 4,337 women) were further analyzed.