|Title||Chronic conditions and mortality among the oldest old.|
|Publication Type||Journal Article|
|Year of Publication||2008|
|Authors||Lee, SJ, Go, AS, Lindquist, K, Bertenthal, D, Covinsky, KE|
|Journal||Am J Public Health|
|Date Published||2008 Jul|
|Keywords||Activities 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|
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.
|User Guide Notes|
|Endnote Keywords|| |
Chronic Disease/Mortality/Age Factors
|Endnote ID|| |
|Alternate Journal||Am J Public Health|
|PubMed Central ID||PMC2424085|
|Grant List||T32 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
HL091179 / HL / NHLBI 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