The development and validation of an index to predict 10-year mortality risk in a longitudinal cohort of older English adults

Abstract

Abstract Background: we aimed to develop and validate a population-representative 10-year mortality risk index for older adults in England. Methods: data were from 10,798 men and women aged 50 years and older in the population-based English Longitudinal Study of Ageing in 2002/03, randomly split into development (n = 5,377) and validation cohorts (n = 5,421). Participants were asked about their sociodemographics, health behaviours, comorbidities, and functional status in the home-based interviews. Variables that were independently associated with all-cause mortality through March 2013 in the development cohort were weighted relative to one another to develop risk point scores for the index that was calibrated in the validation cohort. Results: the validated 10-year mortality risk index assigns points for: increasing age (50–59 years: 0 points; 60–64: 1 point; 65–69: 3 points; 70–74: 5 points; 75–79: 7 points; 80–84: 9 points; ≥85: 12 points), male (2 points), no vigorous physical activity (1 point), smoking (2 points), having a diagnosis of cancer (1 point), chronic lung disease (2 points) or heart failure (4 points), and having difficulty preparing a hot meal (2 points), pushing or pulling large objects (1 point) or walking 100 yards (1 point). In the full study cohort, 10-year mortality rates increased from 1.7% (11/664) in those with 0 points to 95% (189/199) among those with ≥16 points. Conclusion: this highly predictive 10-item mortality risk index is valid in the English population aged 50 years and older. It uses simple information that is often available in research studies and patient reports, and does not require biomarker data to predict mortality.