title: Predictive value of a profile of routine blood measurements on mortality in older persons in the general population: the Leiden 85-plus Study.
abstract: BACKGROUND
  Various questionnaires and performance tests predict mortality in older people. However, most are heterogeneous, laborious and a validated consensus index is not available yet. Since most older people are regularly monitored by laboratory tests, we compared the predictive value of a profile of seven routine laboratory measurements on mortality in older persons in the general population with other predictors of mortality; gait speed and disability in instrumental activities of daily living (IADL).
  
  
  RESULTS
  Within the Leiden 85-plus Study, a prospective population-based study, we followed 562 participants aged 85 years for mortality over five years. At baseline (age 85 years) high-density lipoprotein cholesterol, albumin, alanine transaminase, hemoglobin, creatinin clearance, C-reactive protein and homocysteine were measured. Participants were stratified based on their number of laboratory abnormalities (0, 1, 2-4 and 5-7). The predictive capacity was compared with gait speed (6-meter walking test) and disability in IADL (Groningen Activity Restriction Scale) by C-statistics. At baseline, 418 (74%) 85-year old participants had at least one laboratory abnormality. All cause mortality risk increased with increasing number of laboratory abnormalities to a hazard ratio of 5.64 [95% CI 3.49-9.12] for those with 5-7 laboratory abnormalities (p<0.001) compared to those without abnormalities. The c-statistic was 0.66 [95% CI 0.59-0.69], similar to that of gait speed and disability in IADL.
  
  
  CONCLUSIONS
  In the general population of oldest old, the number of abnormalities in seven routine laboratory measurements predicts five-year mortality as accurately as gait speed and IADL disability.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Anne H
authors.initials: AH
authors.lastname: van Houwelingen
authors.forename: Wendy P J
authors.initials: WP
authors.lastname: den Elzen
authors.forename: Simon P
authors.initials: SP
authors.lastname: Mooijaart
authors.forename: Margot
authors.initials: M
authors.lastname: Heijmans
authors.forename: Jeanet W
authors.initials: JW
authors.lastname: Blom
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006403:Hematologic Tests / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009026:Mortality; D009426:Netherlands; D011237:Predictive Value of Tests