title: Observational cohort study on correlates of mortality in older community-dwelling outpatients: The value of functional assessment.
abstract: OBJECTIVE
  To analyze correlates of mortality with admission features/factors in older community-dwelling outpatients.
  
  
  METHODS
  This is an observational cohort study including 608 patients aged >60 years admitted to the geriatrics outpatient clinics of a university hospital. On admission, demographic characteristics, history of smoking-alcohol consumption, individual comorbidities, individual drugs, number of comorbidities, number of drugs and the components of comprehensive geriatric assessment (functional status, nutritional status, depression and cognition screening) of the patients were recorded. Survival status was assessed through the related official website. The relationship between mortality and recorded parameters were analyzed individually by univariate analyses. Consequently, stepwise forward Cox regression analysis was carried out to detect independent correlates for mortality (for those variables statistically significantly related to mortality.)
  
  
  RESULTS
  The mean age was 73.8 ± 6.9 years. 66.6% of participants were female. The mean follow-up time was 40.4 ± 25.3 months. The mortality rate was 17.8%. Correlates of mortality were calculated using univariate analysis. They were age, sex, nutritional status, activities of daily living (ADL), instrumental ADL, diabetes mellitus (P < 0.001 for all), suspected dementia (P = 0.002), hyperlipidemia (P = 0.048) and total number of diseases (P = 0.025). Independent correlates of mortality were advanced age (HR 1.10, 95% CI 1.06-1.13; P < 0.001, low ADL score (HR 1.22, 95% CI 1.12-1.32; P < 0.001), the presence of diabetes (HR 2.64, 95% CI 1.78-3.91, P < 0.001), male sex (HR 1.68, 95% CI 1.13-2.49; P = 0.01) and suspected dementia (HR 1.51, 95% CI 1.02-2.22; P < 0.05).
  
  
  CONCLUSIONS
  In the present study--taking many factors into consideration--the variables associated with mortality were advanced age, low ADL score, presence of diabetes, male sex and suspected dementia. Functional status emerged as the second most significant factor associated with higher mortality--after advanced age. The present study highlights the importance of functional assessment in geriatric outpatient clinics.
authors.affiliation: Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Gulistan
authors.initials: G
authors.lastname: Bahat
authors.affiliation: Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tufan
authors.affiliation: Department of Radiation Oncology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey.
authors.forename: Zumrut
authors.initials: Z
authors.lastname: Bahat
authors.affiliation: Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Tufan
authors.affiliation: Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Yucel
authors.initials: Y
authors.lastname: Aydin
authors.affiliation: Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Timur Selcuk
authors.initials: TS
authors.lastname: Akpinar
authors.affiliation: Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Nilgun
authors.initials: N
authors.lastname: Erten
authors.affiliation: Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Karan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002423:Cause of Death; D015331:Cohort Studies; D003704:Dementia / Q000401:mortality* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D057187:Independent Living; D053208:Kaplan-Meier Estimate; D008297:Male; D010809:Physical Fitness / Q000502:physiology*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014421:Turkey
keywords: comprehensive geriatric assessment; elderly; functional status; mortality