title: Predicting Mortality up to 14 Years Among Community-Dwelling Adults Aged 65 and Older.
abstract: OBJECTIVE
  Extended validation of an index predicting mortality among community-dwelling US older adults.
  
  
  METHODS
  Examination of the performance of a previously developed index in predicting 10- and 14-year mortality among respondents to the 1997-2000 National Health Interview Surveys (NHIS) using the original development and validation cohorts. Follow-up mortality data are now available through 2011.
  
  
  METHODS
  16,063 respondents from the original development cohort and 8,027 respondents from the original validation cohort. All participants were community dwelling and ≥65 years old.
  
  
  METHODS
  We calculated risk scores for each respondent based on the presence or absence of 11 factors (function, illnesses, behaviors, demographics) that make up the index. Using the Kaplan Meier method, we computed 10- and 14-year mortality estimates for the development and validation cohorts to examine model calibration. We examined model discrimination using the c-index.
  
  
  RESULTS
  Participants in the development and validation cohorts were similar. Participants with risk scores 0-4 had 23% risk of 14-year mortality whereas respondents with risk scores (13+) had 89% risk of 14-year mortality. The c-index of the model in both cohorts was 0.73 for predicting 10-year mortality and 0.72 for predicting 14-year mortality. Overall, 18.4% of adults 65-74 years and 60.2% of adults ≥75 years have >50% risk of mortality in 10 years.
  
  
  CONCLUSIONS
  Our index demonstrated excellent calibration and discrimination in predicting 10- and 14-year mortality among community-dwelling US adults ≥65 years. Information on long-term prognosis is needed to help clinicians and older adults make more informed person-centered medical decisions and to help older adults plan for the future.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Mara A
authors.initials: MA
authors.lastname: Schonberg
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Vicky
authors.initials: V
authors.lastname: Li
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Ellen P
authors.initials: EP
authors.lastname: McCarthy
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D057187:Independent Living; D008017:Life Expectancy; D008297:Male; D009026:Mortality / Q000639:trends; D011379:Prognosis; D018570:Risk Assessment; D013223:Statistics as Topic
keywords: life expectancy; mortality prediction; older adults; prevention