title: Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries.
abstract: Existing mortality prediction models for older adults have been each developed using a single study from the United States or Western Europe. We aimed to develop and validate a 10-year mortality prediction model for older adults using data from developed and developing countries.
  
  
  
  We used data from five cohorts, including data from 16 developed and developing countries: ELSA (English Longitudinal Study of Aging), HRS (Health and Retirement Study), MHAS (Mexican Health and Aging Study), SABE-Sao Paulo (The Health, Well-being and Aging), and SHARE (Survey on Health, Ageing and Retirement in Europe). 35,367 older adults were split into training (two thirds) and test (one third) data sets. Baseline predictors included age, sex, comorbidities, and functional and cognitive measures. We performed an individual participant data meta-analysis using a sex-stratified Cox proportional hazards model, with time to death as the time scale. We validated the model using Harrell's C statistic (discrimination) and the estimated slope between observed and predicted 10-year mortality risk across deciles of risk (calibration).
  
  
  
  During a median of 8.6 years, 8,325 participants died. The final model included age, sex, diabetes, heart disease, lung disease, cancer, smoking, alcohol use, body mass index, physical activity, self-reported health, difficulty with bathing, walking several blocks, and reporting date correctly. The model showed good discrimination (Harrell's C = 0.76) and calibration (slope = 1.005). Models for developed versus developing country cohorts performed equally well when applied to data from developing countries.
  
  
  
  A parsimonious mortality prediction model using data from multiple cohorts in developed and developing countries can be used to predict mortality in older adults in both settings.
authors: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Division of Geriatrics, University of Sao Paulo Medical School, Brazil.
authors: Claudia Kimie
authors: CK
authors: Suemoto
authors: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Peter
authors: P
authors: Ueda
authors: Department of Community Health Sciences and California Center for Population Research, Fielding School of Public Health, UCLA, Los Angeles.
authors: Hiram
authors: H
authors: Beltrán-Sánchez
authors: Department of Epidemiology, School of Public Health and.
authors: Maria Lucia
authors: ML
authors: Lebrão
authors: Department of Medical Surgical Nursing, School of Nursing, University of Sao Paulo, Brazil.
authors: Yeda Aparecida
authors: YA
authors: Duarte
authors: Department of Preventive Medicine and Community Health, University of Texas, Galveston.
authors: Rebeca
authors: R
authors: Wong
authors: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Goodarz
authors: G
authors: Danaei
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D015233:Models, Statistical; D009026:Mortality; D011379:Prognosis; D013997:Time Factors
keywords: Mortality; Older adults; Prediction models; Prevention