The vulnerable elders-13 survey predicts 5-year functional decline and mortality outcomes in older ambulatory care patients.
OBJECTIVE
To test the predictive properties of the Vulnerable Elders-13 Survey (VES-13) a short tool that predicts functional decline and mortality over a 1- to 2-year follow-up interval over a 5-year interval.


METHODS
Longitudinal evaluation with mean follow-up of 4.5 years.


METHODS
Two managed-care organizations.


METHODS
Six hundred forty-nine community-dwelling older adults (> or = 75) enrolled in the Assessing Care of Vulnerable Elders observational study who screened positive for symptoms of falls or fear of falling, bothersome urinary incontinence, or memory problems.


METHODS
VES-13 score (range 1-10, higher score indicates worse prognosis), functional decline (decline in count of 5 activities of daily living or nursing home entry), and deaths.


RESULTS
Higher VES-13 scores were associated with greater predicted probability of death and decline in older patients over a mean observation period of 4.5 years. For each additional VES-13 point, the odds of the combined outcome of functional decline or death was 1.37 (95% confidence interval (CI)=1.25-1.50), and the area under the receiver operating curve was 0.75 (95% CI=0.71-0.80). In the Cox proportional hazards model predicting time to death, the hazard ratio was 1.23 (95% CI=1.19-1.27) per additional VES-13 point.


CONCLUSIONS
This study extends the utility of the VES-13 to clinical decisions that require longer-term prognostic estimates of functional status and survival.
Division of Geriatrics, University of California at Los Angeles, Los Angeles, California, USA. lmin@mednet.ucla.edu
Lillian
L
Min
William
W
Yoon
Jeff
J
Mariano
Neil S
NS
Wenger
Marc N
MN
Elliott
Caren
C
Kamberg
Debra
D
Saliba
D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000401:mortality; D002908:Chronic Disease / Q000401:mortality*; D003704:Dementia / Q000401:mortality; D004185:Disability Evaluation; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D019983:Guideline Adherence; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D051346:Mobility Limitation; D016017:Odds Ratio; D011379:Prognosis; D016019:Survival Analysis; D014549:Urinary Incontinence / Q000401:mortality