Predicting 10-year Mortality for Older Adults
Healthy aging is about living not the opposite. On the other hand, we all know at some level of consciousness that our days on earth are limited. So the question really is: what are my chances of living another 10 years if I am over 50? That question was the subject of a recent report in the Journal of the American Medical Association.
This intriguing study involved analyzing what happened to 20,000 people over 10 years beginning in 1998 who were enrolled in a California research study. During that time, 6,000 or 33 percent of these 50 or older people died. The fact that so many died means that the data is likely to be useful in finding out the risk factors for death within 10 years. The people who survived can be compared to those who died to formulate a probability of death/survival based on certain health-based data.
The authors argue that the simple prediction test is not meant for lay people to take alone, but to be done with their physician. Both the patient and the doctor should use the information to decide how aggressive to be in ordering test, procedures, or even medicines that all carry significant risks. In other words, if one's longevity is limited it may be wise to forego risky interventions since the risks could outweigh any long term benefits.
The test is simple, consisting of 12 questions with answers that produce points for each answer that range from 0 to 3. The more points one has at the end of the test, the lower the survival for 10 years. The questions are listed in the table along with the points for each answer and the form clearly states that this test needs to be done with a physician rather than just for one's curiosity.
Of note is the fact that men start with two points because men die before women. Age also adds points since the older we are the less time we have left. Evidence of any physical limitations adds points and diminished survival. The highest score of 26 has a 95 percent chance of dying within 10 years and a zero score gives a woman a three percent chance of dying in the 10 years.
It would be a good idea to go over this survey with your physician to inform you both of your overall probability of survival, remembering that this is pure probability based on data from others and does not take into account individual factors that may make the survey inapplicable to you. Again, your physician can advise you about this. The link at the top of this article will take you to the report, but the reference for you and your physician is: Cruz, et al. JAMA 309:874-876, 2013.
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