Journal article
Prediction of disability-free survival in healthy older people
GeroScience, v 44(3), pp 1641-1655
2022
PMID: 35420334
Featured in Collection : UN Sustainable Development Goals @ Drexel
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)
Metrics
Details
- Title
- Prediction of disability-free survival in healthy older people
- Creators
- Johannes Tobias Neumann - Universität HamburgLe T. P. Thao - Monash UniversityAnne M. Murray - Berman Center for Outcomes and Clinical ResearchEmily Callander - Monash UniversityPrudence R. Carr - Monash UniversityMark R. Nelson - University of TasmaniaRory Wolfe - Monash UniversityRobyn L. Woods - Monash UniversityChristopher M. Reid - Curtin UniversityRaj C. Shah - Rush UniversityAnne B. Newman - University of PittsburghJeff D. Williamson - Wake Forest UniversityAndrew M. Tonkin - Monash UniversityJohn J. McNeil - Monash UniversityASPREE InvestigatorsJessica R Barson - College of Medicine (2002-)
- Publication Details
- GeroScience, v 44(3), pp 1641-1655
- Publisher
- Springer International Publishing
- Grant note
- Monash University
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurobiology and Anatomy; College of Medicine; Drexel University
- Web of Science ID
- WOS:000782553900001
- Scopus ID
- 2-s2.0-85132455784
- Other Identifier
- 991020099677004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Geriatrics & Gerontology