Journal article
Prediction of disability-free survival in healthy older people
GeroScience, Vol.44(3), pp.1641-1655
04/14/2022
DOI: 10.1007/s11357-022-00547-x
PMCID: PMC9213595
PMID: 35420334
Abstract
Prolonging survival in good health is a fundamental societal goal. However, the leading determinants of disability-free survival in healthy older people have not been well established. Data from ASPREE, a bi-national placebo-controlled trial of aspirin with 4.7 years median follow-up, was analysed. At enrolment, participants were healthy and without prior cardiovascular events, dementia or persistent physical disability. Disability-free survival outcome was defined as absence of dementia, persistent disability or death. Selection of potential predictors from amongst 25 biomedical, psychosocial and lifestyle variables including recognized geriatric risk factors, utilizing a machine-learning approach. Separate models were developed for men and women. The selected predictors were evaluated in a multivariable Cox proportional hazards model and validated internally by bootstrapping. We included 19,114 Australian and US participants aged ≥65 years (median 74 years, IQR 71.6–77.7). Common predictors of a worse prognosis in both sexes included higher age, lower Modified Mini-Mental State Examination score, lower gait speed, lower grip strength and abnormal (low or elevated) body mass index. Additional risk factors for men included current smoking, and abnormal eGFR. In women, diabetes and depression were additional predictors. The biased-corrected areas under the receiver operating characteristic curves for the final prognostic models at 5 years were 0.72 for men and 0.75 for women. Final models showed good calibration between the observed and predicted risks. We developed a prediction model in which age, cognitive function and gait speed were the strongest predictors of disability-free survival in healthy older people.
Trial registration
Clinicaltrials.gov
(NCT01038583)
Details
- Title: Subtitle
- Prediction of disability-free survival in healthy older people
- Creators
- Johannes Tobias Neumann - Monash UniversityLe T. P. Thao - Monash UniversityAnne M. Murray - Berman Center for Outcomes and Clinical ResearchEmily Callander - Monash UniversityPrudence R. Carr - Monash UniversityMark R. Nelson - Monash UniversityRory Wolfe - Monash UniversityRobyn L. Woods - Monash UniversityChristopher M. Reid - Monash UniversityRaj C. Shah - Rush University Medical CenterAnne B. Newman - University of PittsburghJeff D. Williamson - Wake Forest UniversityAndrew M. Tonkin - Monash UniversityJohn J. McNeil - Monash UniversityASPREE Investigators
- Contributors
- Michael E Ernst (Contributor) - University of Iowa, Pharmacy Practice and Science
- Resource Type
- Journal article
- Publication Details
- GeroScience, Vol.44(3), pp.1641-1655
- DOI
- 10.1007/s11357-022-00547-x
- PMID
- 35420334
- PMCID
- PMC9213595
- NLM abbreviation
- Geroscience
- ISSN
- 2509-2715
- eISSN
- 2509-2723
- Publisher
- Springer International Publishing
- Grant note
- Monash University
- Language
- English
- Date published
- 04/14/2022
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297335702771
Metrics
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