William J. Hall, MD, MACP
Does an 11-item index predict 5-year and 9-year mortality in community-dwelling elderly persons?
Cohort study using data from annual US National Health Interview Surveys (NHIS, 1997 to 2004) with probabilistic matching to the National Death Index. Data from 1997 to 2000 surveys (original cohort, previously used to develop and validate a 5-y mortality index) were used to evaluate the index for predicting 9-year mortality; data from 2001 to 2004 surveys (new validation cohort) were used for validation of the index for predicting 5-year mortality.
Population-based study in the USA.
Adults ≥ 65 years of age who participated in the NHIS (original cohort, n = 24 139, 58% women, 8.8% ≥ 85 years of age; new validation cohort, n = 22 057, 57% women, 9.7% ≥ 85 years of age). Exclusion criteria included dementia.
11-item index (score range 0 to 31) included age; sex; smoking status; body mass index (BMI); general health status; dependency in activities of daily living; difficulty walking 0.25 mile; hospitalization in the past year; and health professional–confirmed emphysema/chronic bronchitis, diabetes, or cancer (other than nonmelanoma skin cancer).
5-year and 9-year mortality.
8387 persons in the original cohort and 3622 in the new validation cohort died. In the new validation cohort, 5-year mortality was 2% in participants with index scores ≤ 1 and 69% in those with index scores ≥ 18 (Table); c-index for risk discrimination was 0.75. In the original cohort, 9-year mortality was 7% to 11% in participants with index scores ≤ 1 and 89% to 92% in those with index scores ≥ 18 (Table).
An 11-item index predicted 5-year and 9-year mortality in community-dwelling elderly persons.
*Only participants with complete data were included (new validation cohort, n = 20 974; original cohort, n = 23 115). Analyses were weighted for US population estimates and adjusted for nonresponse and mortality nonlinkage.
†Score range 0 to 31 on 11-item index: age; sex; smoking status; body mass index; general health status; dependency in activities of daily living; difficulty walking; hospitalization in past year; and health professional–confirmed emphysema/chronic bronchitis, diabetes, or cancer other than nonmelanoma skin cancer.
Hall WJ. An 11-item index predicted 5-year and 9-year mortality in community-dwelling elderly adults. Ann Intern Med. ;156:JC1–13. doi: 10.7326/0003-4819-156-2-201201170-02013
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Published: Ann Intern Med. 2012;156(2):JC1-13.
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