Discrimination ability of comorbidity, frailty, and subjective health to predict mortality in community-dwelling older people: Population based prospective cohort study

Sasmita Kusumastuti; Thomas Alexander Gerds; Rikke Lund; Erik Lykke Mortensen; Rudi G. J. Westendorp

doi:10.1016/j.ejim.2017.05.016

Discrimination ability of comorbidity, frailty, and subjective health to predict mortality in community-dwelling older people: Population based prospective cohort study

Sasmita Kusumastuti, Thomas Alexander Gerds, Rikke Lund, Erik Lykke Mortensen, Rudi G. J. Westendorp

14 Citationer (Scopus)

Abstract

Objective To investigate the added value of comorbidity, frailty, and subjective health to mortality predictions in community-dwelling older people and whether it changes with increasing age. Participants 36,751 community-dwelling subjects aged 50–100 from the longitudinal Survey of Health, Ageing, and Retirement in Europe. Methods Mortality risk associated with Comorbidity Index, Frailty Index, Frailty Phenotype, and subjective health was analysed using Cox regression. The extent to which health indicators modified individual mortality risk predictions was examined and the added ability to discriminate mortality risks was assessed. Main outcome measures Three-year mortality risks, hazard ratios, change in individual mortality risks, three-year area under the receiver operating characteristic curve (AUC). Results Three-year mortality risks increased 41-folds within an age span of 50 years. Hazard ratios per change in health indicator became less significant with increasing age (p-value < 0·001). AUC for three-year mortality prediction based on age and sex was 76·9% (95% CI 75·5% to 78·3%). Information on health indicators modified individual three-year mortality risk predictions up to 30%, both upwards and downwards, each adding < 2% discriminative power. The added discrimination ability of all health indicators gradually declined from an extra 4% at age 50–59 to < 1% in the oldest old. Trends were similar for one-year mortality and not different between sexes, levels of education, and household income. Conclusion Calendar age encompasses most of the discrimination ability to predict mortality. The added value of comorbidity, frailty, and subjective health to mortality predictions decreases with increasing age.

Originalsprog	Engelsk
Tidsskrift	European Journal of Internal Medicine
Vol/bind	42
Sider (fra-til)	29-38
Antal sider	10
ISSN	0953-6205
DOI	https://doi.org/10.1016/j.ejim.2017.05.016
Status	Udgivet - jul. 2017

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10.1016/j.ejim.2017.05.016

Citationsformater

Discrimination ability of comorbidity, frailty, and subjective health to predict mortality in community-dwelling older people : Population based prospective cohort study. / Kusumastuti, Sasmita ; Gerds, Thomas Alexander ; Lund, Rikke et al.

I: European Journal of Internal Medicine, Bind 42, 07.2017, s. 29-38.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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title = "Discrimination ability of comorbidity, frailty, and subjective health to predict mortality in community-dwelling older people: Population based prospective cohort study",

abstract = "Objective To investigate the added value of comorbidity, frailty, and subjective health to mortality predictions in community-dwelling older people and whether it changes with increasing age. Participants 36,751 community-dwelling subjects aged 50–100 from the longitudinal Survey of Health, Ageing, and Retirement in Europe. Methods Mortality risk associated with Comorbidity Index, Frailty Index, Frailty Phenotype, and subjective health was analysed using Cox regression. The extent to which health indicators modified individual mortality risk predictions was examined and the added ability to discriminate mortality risks was assessed. Main outcome measures Three-year mortality risks, hazard ratios, change in individual mortality risks, three-year area under the receiver operating characteristic curve (AUC). Results Three-year mortality risks increased 41-folds within an age span of 50 years. Hazard ratios per change in health indicator became less significant with increasing age (p-value < 0·001). AUC for three-year mortality prediction based on age and sex was 76·9% (95% CI 75·5% to 78·3%). Information on health indicators modified individual three-year mortality risk predictions up to 30%, both upwards and downwards, each adding < 2% discriminative power. The added discrimination ability of all health indicators gradually declined from an extra 4% at age 50–59 to < 1% in the oldest old. Trends were similar for one-year mortality and not different between sexes, levels of education, and household income. Conclusion Calendar age encompasses most of the discrimination ability to predict mortality. The added value of comorbidity, frailty, and subjective health to mortality predictions decreases with increasing age.",

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author = "Sasmita Kusumastuti and Gerds, {Thomas Alexander} and Rikke Lund and Mortensen, {Erik Lykke} and Westendorp, {Rudi G. J.}",

year = "2017",

month = jul,

doi = "10.1016/j.ejim.2017.05.016",

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T2 - Population based prospective cohort study

AU - Kusumastuti, Sasmita

AU - Gerds, Thomas Alexander

AU - Lund, Rikke

AU - Mortensen, Erik Lykke

AU - Westendorp, Rudi G. J.

PY - 2017/7

Y1 - 2017/7

N2 - Objective To investigate the added value of comorbidity, frailty, and subjective health to mortality predictions in community-dwelling older people and whether it changes with increasing age. Participants 36,751 community-dwelling subjects aged 50–100 from the longitudinal Survey of Health, Ageing, and Retirement in Europe. Methods Mortality risk associated with Comorbidity Index, Frailty Index, Frailty Phenotype, and subjective health was analysed using Cox regression. The extent to which health indicators modified individual mortality risk predictions was examined and the added ability to discriminate mortality risks was assessed. Main outcome measures Three-year mortality risks, hazard ratios, change in individual mortality risks, three-year area under the receiver operating characteristic curve (AUC). Results Three-year mortality risks increased 41-folds within an age span of 50 years. Hazard ratios per change in health indicator became less significant with increasing age (p-value < 0·001). AUC for three-year mortality prediction based on age and sex was 76·9% (95% CI 75·5% to 78·3%). Information on health indicators modified individual three-year mortality risk predictions up to 30%, both upwards and downwards, each adding < 2% discriminative power. The added discrimination ability of all health indicators gradually declined from an extra 4% at age 50–59 to < 1% in the oldest old. Trends were similar for one-year mortality and not different between sexes, levels of education, and household income. Conclusion Calendar age encompasses most of the discrimination ability to predict mortality. The added value of comorbidity, frailty, and subjective health to mortality predictions decreases with increasing age.

AB - Objective To investigate the added value of comorbidity, frailty, and subjective health to mortality predictions in community-dwelling older people and whether it changes with increasing age. Participants 36,751 community-dwelling subjects aged 50–100 from the longitudinal Survey of Health, Ageing, and Retirement in Europe. Methods Mortality risk associated with Comorbidity Index, Frailty Index, Frailty Phenotype, and subjective health was analysed using Cox regression. The extent to which health indicators modified individual mortality risk predictions was examined and the added ability to discriminate mortality risks was assessed. Main outcome measures Three-year mortality risks, hazard ratios, change in individual mortality risks, three-year area under the receiver operating characteristic curve (AUC). Results Three-year mortality risks increased 41-folds within an age span of 50 years. Hazard ratios per change in health indicator became less significant with increasing age (p-value < 0·001). AUC for three-year mortality prediction based on age and sex was 76·9% (95% CI 75·5% to 78·3%). Information on health indicators modified individual three-year mortality risk predictions up to 30%, both upwards and downwards, each adding < 2% discriminative power. The added discrimination ability of all health indicators gradually declined from an extra 4% at age 50–59 to < 1% in the oldest old. Trends were similar for one-year mortality and not different between sexes, levels of education, and household income. Conclusion Calendar age encompasses most of the discrimination ability to predict mortality. The added value of comorbidity, frailty, and subjective health to mortality predictions decreases with increasing age.

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DO - 10.1016/j.ejim.2017.05.016

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JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

ER -

Discrimination ability of comorbidity, frailty, and subjective health to predict mortality in community-dwelling older people: Population based prospective cohort study

Abstract

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