Evidence of Functional Declining and Global Comorbidity Measured at Baseline Proved to Be the Strongest Predictors for Long-term Death in Elderly Community Residents Aged 85 Years: a 5-year Follow-up Evaluation, the OCTABAIX Study

Overview

Journal Clin Interv Aging

Publisher Dove Medical Press

Specialty Geriatrics

Date 2016 May 5

PMID 27143867

Citations 9

Authors

Francesc Formiga

Assumpta Ferrer

Gloria Padros

Abelardo Montero

Carme Gimenez-Argente

Xavier Corbella

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the predictive value of functional impairment, chronic conditions, and laboratory biomarkers of aging for predicting 5-year mortality in the elderly aged 85 years.

Methods: Predictive value for mortality of different geriatric assessments carried out during the OCTABAIX study was evaluated after 5 years of follow-up in 328 subjects aged 85 years. Measurements included assessment of functional status comorbidity, along with laboratory tests on vitamin D, cholesterol, CD4/CD8 ratio, hemoglobin, and serum thyrotropin.

Results: Overall, the mortality rate after 5 years of follow-up was 42.07%. Bivariate analysis showed that patients who survived were predominantly female (P=0.02), and they showed a significantly better baseline functional status for both basic (P<0.001) and instrumental (P<0.001) activities of daily living (Barthel and Lawton index), better cognitive performance (Spanish version of the Mini-Mental State Examination) (P<0.001), lower comorbidity conditions (Charlson) (P<0.001), lower nutritional risk (Mini Nutritional Assessment) (P<0.001), lower risk of falls (Tinetti gait scale) (P<0.001), less percentage of heart failure (P=0.03) and chronic obstructive pulmonary disease (P=0.03), and took less chronic prescription drugs (P=0.002) than nonsurvivors. Multivariate Cox regression analysis identified a decreased score in the Lawton index (hazard ratio 0.86, 95% confidence interval: 0.78-0.91) and higher comorbidity conditions (hazard ratio 1.20, 95% confidence interval: 1.08-1.33) as independent predictors of mortality at 5 years in the studied population.

Conclusion: The ability to perform instrumental activities of daily living and the global comorbidity assessed at baseline were the predictors of death, identified in our 85-year-old community-dwelling subjects after 5 years of follow-up.

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