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Predicting Mortality up to 14 Years Among Community‐Dwelling Adults Aged 65 and Older
Author(s) -
Schonberg Mara A.,
Li Vicky,
Marcantonio Edward R.,
Davis Roger B.,
McCarthy Ellen P.
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14805
Subject(s) - medicine , respondent , national death index , demography , cohort , gerontology , cohort study , mortality rate , demographics , index (typography) , confidence interval , surgery , hazard ratio , sociology , world wide web , political science , computer science , law
Objectives Extended validation of an index predicting mortality among community‐dwelling US older adults. Design/Setting Examination of the performance of a previously developed index in predicting 10‐ and 14‐year mortality among respondents to the 1997–2000 National Health Interview Surveys ( NHIS ) using the original development and validation cohorts. Follow‐up mortality data are now available through 2011. Participants 16,063 respondents from the original development cohort and 8,027 respondents from the original validation cohort. All participants were community dwelling and ≥65 years old. Measurements We calculated risk scores for each respondent based on the presence or absence of 11 factors (function, illnesses, behaviors, demographics) that make up the index. Using the Kaplan Meier method, we computed 10‐ and 14‐year mortality estimates for the development and validation cohorts to examine model calibration. We examined model discrimination using the c‐index. Results Participants in the development and validation cohorts were similar. Participants with risk scores 0–4 had 23% risk of 14‐year mortality whereas respondents with risk scores (13+) had 89% risk of 14‐year mortality. The c‐index of the model in both cohorts was 0.73 for predicting 10‐year mortality and 0.72 for predicting 14‐year mortality. Overall, 18.4% of adults 65–74 years and 60.2% of adults ≥75 years have >50% risk of mortality in 10 years. Conclusions Our index demonstrated excellent calibration and discrimination in predicting 10‐ and 14‐year mortality among community‐dwelling US adults ≥65 years. Information on long‐term prognosis is needed to help clinicians and older adults make more informed person‐centered medical decisions and to help older adults plan for the future.