March 20th, 2013 at 10:10 am
Bookmark and Share

Estimating the risk of mortality for elders

by Dorian Martin

My 87-year-old father has a number of health issues. He has a bad back and difficulty walking. His lack of mobility makes it difficulty for him to get in and out of the bathtub in order to bathe. He also has high blood pressure and is prediabetic. So how bad is his health picture, especially in terms of how long he might live?

That’s an answer that University of California, San Francisco (UCSF) researchers want to help physicians discover. These researchers developed a 10-year mortality index for doctors to use as a guide when they see older patients in a clinical setting. This new tool lists selected factors associated with longevity, while additional conditions such as environmental concerns and chronic diseases could also affect how long a person lives.

According to the summary in the Journal of the American Medical Association, this information on a patient’s life expectancy could help in determining whether patients would benefit from certain medical interventions: “Preventive interventions, such as cancer screening, expose patients to immediate risks with delayed benefits, suggesting that risks outweigh benefits in patients with limited life expectancy.”

What can caregivers look out for?

The UCSF study used data from more than 20,000 adults over the age of 50 between 1998 and 2008 to compile an index of factors related to mortality. “Not one particular risk factor tells you whether or not you are likely to survive, but a host of attributes about your life and your medical conditions will give you a clearer picture,” said Dr. Marisa Cruz, lead researcher for the study.

Points are given for different items on the list, such as specific health conditions. Men automatically receive two points on the basis of gender. For age, there is a sliding scale: Those at the younger side of the scale (ages 60-64) get one point, while seven points are awarded for those who are at least 85 years of age. Some other elements of the index receive a varying number of points:

  1. Weight and height: If the elder has a body mass index (BMI) that is less than 25 percent — 1 point
  2. Blood sugar: If the elder has been diagnosed with diabetes or high blood sugar — 1 point
  3. Cancer: If the elder has been diagnosed with cancer or a malignant tumor, with the exception of minor skin cancers — 2 points
  4. Lung capacity: If the elder has a chronic lung disease that inhibits normal activities or requires that oxygen be used while at home — 2 points
  5. Heart: If the elder has been diagnosed with congestive heart failure — 2 points
  6. Smoking: If the elder smoked cigarettes sometime during the previous week — 2 points
  7. Cleanliness: If the person experiences difficulty with bathing or showering because of a health or memory problem — 2 points
  8. Money: If the elder experiences difficulty managing money such as paying bills or tracking expenses due to a health or memory problem — 2 points
  9. Mobility: If the person has limited mobility, such as difficulty walking several blocks — 2 points
  10. Strength: If the person experiences difficulty pulling or pushing a large object, such as a living room chair — 1 point

The mortality index is not intended as medical advice or as a tool for self-diagnosis, yet it might provide a window into the overall health status of an individual. While the index does not specifically address dementia, memory problems are possible causes for a few of the concerns listed.

What can a caregiver do?

If your elder is starting to display or experience potential risk factors such as those listed, talk to his or her physician to see if you can help develop a plan of action. Also, encourage the individual to lead a healthy lifestyle, including diet, exercise and staying socially engaged and mentally stimulated.

For more thoughts on a related topic, you can refer to the article Symptoms of decline in elders’ health: should family members intervene?

Posted in Caregiving, Death | No Comments »
Tags: ,

Leave a Reply