Age, Intensity of Treatment, and Surviving Serious Illness FREE

When they have a serious illness, older people tend to do worse than younger ones do. Some people think this may be, in part, because older people tend to get less intense treatment than younger ones.

The researchers wanted to examine the link between age and the likelihood of surviving a major illness. They wanted to see if the intensity of treatment played a role in this relationship.

The researchers studied 9105 patients who were hospitalized with a serious illness, including heart failure, liver failure, lung failure, or cancer. To be in the study, patients had to have 50% chance of surviving for 6 months. The study was done at five teaching hospitals in Boston, Massachusetts; Los Angeles, California; Marshfield, Wisconsin; Durham, North Carolina; and Cleveland, Ohio.

With patients' permission, the researchers collected detailed information from medical records. They also recorded whether patients were alive 6 months later by reviewing medical records and death records and by contacting patients, their families, and their doctors. The researchers analyzed this information to examine the relationship between age and being alive at 6 months while accounting for other important factors, such as the patient's social status, sex, ability to care for themselves before they got sick, and the severity of the illness.

As expected, just over half of the study patients were alive 6 months later. The older a patient was, the more likely he or she was to die. A 55 year-old patient had a 44% chance of being dead 6 months later. The chances of dying within 6 months of the serious illness increases as people get older: 48% for 65-year-olds, 53% for 75-year-olds, and 60% for 85-year-olds. The thing that best predicted who would die was how sick the patient was at the time they entered the study. The less intense treatment given to older patients did not explain why they did worse.

This study could not explain exactly why older persons did worse.

The most important factor in how well a person does when they have a serious illness is the level of sickness. In general, however, older persons do a little worse than younger ones who are just as sick. Less-intense treatment for older persons does not appear to be the reason older persons do worse.