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01.12.2019 | Research article | Ausgabe 1/2019 Open Access

BMC Medicine 1/2019

Comparing the prognostic value of geriatric health indicators: a population-based study

Zeitschrift:
BMC Medicine > Ausgabe 1/2019
Autoren:
Alberto Zucchelli, Davide L. Vetrano, Giulia Grande, Amaia Calderón-Larrañaga, Laura Fratiglioni, Alessandra Marengoni, Debora Rizzuto
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12916-019-1418-2) contains supplementary material, which is available to authorized users.
Alberto Zucchelli and Davide L Vetrano are first shared authorship.
Alessandra Marengoni and Debora Rizzuto are last shared authorship.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Background

The identification of individuals at increased risk of poor health-related outcomes is a priority. Geriatric research has proposed several indicators shown to be associated with these outcomes, but a head-to-head comparison of their predictive accuracy is still lacking. We therefore aimed to compare the accuracy of five geriatric health indicators in predicting different outcomes among older persons: frailty index (FI), frailty phenotype (FP), walking speed (WS), multimorbidity, and a summary score including clinical diagnoses, functioning, and disability (the Health Assessment Tool; HAT).

Methods

Data were retrieved from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing longitudinal study including 3363 people aged 60+. To inspect the accuracy of geriatric health indicators, we employed areas under the receiver operating characteristic curve (AUC) for the prediction of 3-year and 5-year mortality, 1-year and 3-year unplanned hospitalizations (1+), and contacts with healthcare providers in the 6 months before and after baseline evaluation (2+).

Results

FI, WS, and HAT showed the best accuracy in the prediction of mortality [AUC(95%CI) for 3-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.87), 0.87 (0.85–0.88) and AUC(95%CI) for 5-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.86), 0.86 (0.85–0.88), respectively]. Unplanned hospitalizations were better predicted by the FI [AUC(95%CI) 1-year 0.73 (0.71–0.76); 3-year 0.72 (0.70–0.73)] and HAT [AUC(95%CI) 1-year 0.73 (0.71–0.75); 3-year 0.71 (0.69–0.73)]. The most accurate predictor of multiple contacts with healthcare providers was multimorbidity [AUC(95%CI) 0.67 (0.65–0.68)]. Predictions were generally less accurate among younger individuals (< 78 years old).

Conclusion

Specific geriatric health indicators predict clinical outcomes with different accuracy. Comprehensive indicators (HAT, FI, WS) perform better in predicting mortality and hospitalization. Multimorbidity exhibits the best accuracy in the prediction of multiple contacts with providers.
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