title: Which parameters affect long-term mortality in older adults: is comprehensive geriatric assessment a predictor of mortality?
abstract: BACKGROUND
  Determining predictors of mortality among older adults might help identify high-risk patients and enable timely intervention.
  
  
  OBJECTIVE
  The aim of the study was to identify which variables predict geriatric outpatient mortality, using routine geriatric assessment tools.
  
  
  METHODS
  We analyzed the data of 1141 patients who were admitted to the geriatric medicine outpatient clinic between 2001 and 2004. Comprehensive geriatric assessment was performed by an interdisciplinary geriatric team. Mortality rate was determined in 2015. The parameters predicting survival were examined.
  
  
  RESULTS
  Median age of the patients (415 male, 726 female) was 71.7 years (53-95 years). Mean survival time was 12.2 years (95 % CI; 12-12.4 years). In multivariate analysis, age (OR: 1.16, 95 % CI: 1.09-1.23, p < 0.001), smoking (OR: 2.51, 95 % CI: 1.18-5.35, p = 0.017) and metabolic syndrome (OR: 2.20, 95 % CI: 1.05-4.64, p = 0.038) were found to be independent risk factors for mortality. MNA-SF scores (OR: 0.84, 95 % CI: 0.71-1.00, p = 0.050) and free T3 levels (OR: 0.70, 95 % CI: 0.49-1.00, p = 0.052) had borderline significance.
  
  
  CONCLUSIONS
  The present study showed that the risk conferred by metabolic syndrome is beyond its individual components. Our findings confirm previous studies on the prognostic role of nutritional status, as reflected by MNA-SF. Serum fT3, a simple laboratory test, may also be used in geriatric outpatient clinics to identify individuals at risk.
  
  
  CONCLUSIONS
  The results of the study demonstrated the need for addressing modifiable risk factors such as smoking, metabolic syndrome, and undernutrition in older adults.
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kara
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. alpabusra@hotmail.com.
authors.forename: Busra
authors.initials: B
authors.lastname: Canbaz
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Muhammet Cemal
authors.initials: MC
authors.lastname: Kizilarslanoglu
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Gunes
authors.initials: G
authors.lastname: Arik
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Sumer
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Gozde Sengul
authors.initials: GS
authors.lastname: Aycicek
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hacer Dogan
authors.initials: HD
authors.lastname: Varan
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Kilic
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Rana Tuna
authors.initials: RT
authors.lastname: Dogru
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Ankara University Medical School, Ankara, Turkey.
authors.forename: Esat
authors.initials: E
authors.lastname: Cınar
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Kuyumcu
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yesil
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Gazi University Medical School, Ankara, Turkey.
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Ulger
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Burcu Balam
authors.initials: BB
authors.lastname: Yavuz
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Halil
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cankurtaran
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000401:mortality; D008875:Middle Aged; D009752:Nutritional Status; D012307:Risk Factors; D012907:Smoking / Q000401:mortality
keywords: Comprehensive geriatric assessment; Malnutrition; Metabolic syndrome; Mortality; Smoking