Index May Help Predict 10-Year Mortality Among Older Adults

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Index May Help Predict 10-Year Mortality Among Older Adults

Main Category: Seniors / Aging

Article Date: 07 Mar 2013

"Recent guidelines recommend considering patients' life expectancy when deciding whether to pursue preventive interventions with long lag times to benefit (7 years or more) such as colorectal cancer screening and intensive glycemic control for diabetes. However, most mortality indices have focused on short-term risk (5 years or less)," writes Marisa Cruz, M.D., of the University of California, San Francisco, and colleagues. The researchers examined whether their previously developed 4-year mortality index accurately predicted 10-year mortality.

As reported in a Research Letter, this analysis used 1998 data from the Health and Retirement Study (HRS), a nationally representative cohort of community-dwelling U.S. adults older than 50 years. The primary predictor was a 12-item mortality index, and participants received points depending on answers to the following: age; sex; current tobacco use; body mass index; diabetes; nonskin cancers; chronic lung disease; heart failure; difficulty bathing; difficulty managing finances; difficulty walking several blocks; and difficulty pushing/pulling large objects. The primary outcome was death through 2008 (10-year mortality). A risk score was calculated for each participant by summing the points for each risk factor present.

The researchers found that in the development cohort, 10-year mortality rates ranged from 2.5 percent (n=12/486) for participants with 0 points to 96 percent (n=298/310) for participants with 14 or more points. In the validation cohort, 10-year mortality rates ranged from 2.3 percent (n=8/354) to 93 percent (n= 239/257).

"We validated a mortality index that accurately stratified older adults into groups at varying risk for 10-year mortality," the authors write. "Patients identified by this index as having a high risk of 10-year mortality may be more likely to be harmed by preventive interventions with long lag times to benefit, whereas patients identified as having a low risk of 10-year mortality may be good candidates for such interventions."

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