Chronic conditions and mortality among the oldest old.

TitleChronic conditions and mortality among the oldest old.
Publication TypeJournal Article
Year of Publication2008
AuthorsLee, SJ, Go, AS, Lindquist, K, Bertenthal, D, Covinsky, KE
JournalAm J Public Health
Volume98
Issue7
Pagination1209-14
Date Published2008 Jul
ISSN Number1541-0048
Call Numbernewpubs20080822_AJPH1209
KeywordsActivities of Daily Living, Aged, Aged, 80 and over, Chronic disease, Female, Health Behavior, Health Status, Humans, Male, Middle Aged, Models, Statistical, Predictive Value of Tests, Proportional Hazards Models, Reproducibility of Results, Risk Adjustment, Severity of Illness Index, Socioeconomic factors, Survival Analysis, United States
Abstract

OBJECTIVES: We sought to determine whether chronic conditions and functional limitations are equally predictive of mortality among older adults.

METHODS: Participants in the 1998 wave of the Health and Retirement Study (N=19430) were divided into groups by decades of age, and their vital status in 2004 was determined. We used multivariate Cox regression to determine the ability of chronic conditions and functional limitations to predict mortality.

RESULTS: As age increased, the ability of chronic conditions to predict mortality declined rapidly, whereas the ability of functional limitations to predict mortality declined more slowly. In younger participants (aged 50-59 years), chronic conditions were stronger predictors of death than were functional limitations (Harrell C statistic 0.78 vs. 0.73; P=.001). In older participants (aged 90-99 years), functional limitations were stronger predictors of death than were chronic conditions (Harrell C statistic 0.67 vs. 0.61; P=.004).

CONCLUSIONS: The importance of chronic conditions as a predictor of death declined rapidly with increasing age. Therefore, risk-adjustment models that only consider comorbidities when comparing mortality rates across providers may be inadequate for adults older than 80 years.

Notes

PMID 18511714

DOI10.2105/AJPH.2007.130955
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/18511714?dopt=Abstract

Endnote Keywords

Chronic Disease/Mortality/Age Factors

Endnote ID

19110

Alternate JournalAm J Public Health
Citation Key7232
PubMed ID18511714
PubMed Central IDPMC2424085
Grant ListT32 AG000212-15 / AG / NIA NIH HHS / United States
T32 AG000212 / AG / NIA NIH HHS / United States
T32 AG000212-16 / AG / NIA NIH HHS / United States
U01 DK060902 / DK / NIDDK NIH HHS / United States
U19 HL091179 / HL / NHLBI NIH HHS / United States
R01 AG023626 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States
DK060902 / DK / NIDDK NIH HHS / United States
HL091179 / HL / NHLBI NIH HHS / United States