Multiple, but not traditional risk factors predict mortality in older people: the Concord Health and Ageing in Men Project.
This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005-2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors delete time until of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of delete time to time to mortality included in the final model (p < 0.05) were older age, body mass index < 20 kg m(2), high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong non-drinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a younger population, including high blood pressure, hypercholesterolaemia, overweight and obesity and diabetes, were not independent predictors of mortality in this population of older men.
Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Hospital Road, Concord, NSW, Sydney, 2137, Australia, vasant.hirani@sydney.edu.au.
Vasant
V
Hirani
Vasi
V
Naganathan
Fiona
F
Blyth
David G
DG
Le Couteur
Danijela
D
Gnjidic
Fiona F
FF
Stanaway
Markus J
MJ
Seibel
Louise M
LM
Waite
David J
DJ
Handelsman
Robert G
RG
Cumming
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000704:Analysis of Variance; D000886:Anthropometry; D001315:Australia; D001774:Blood Chemical Analysis; D001795:Blood Pressure Determination; D015331:Cohort Studies; D006801:Humans; D008019:Life Style; D008297:Male; D054526:Men's Health; D009026:Mortality / Q000639:trends*; D010809:Physical Fitness; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population