Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures
Abstract Objectives We aimed to replicate existing international (US and UK) mortality indices using Irish data. We developed and validated a four-year mortality index for adults aged 50 + in Ireland and compared performance with these international indices. We then extended this model by including...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-03196-z |
| _version_ | 1811334607796174848 |
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| author | Soraya Matthews Mark Ward Anne Nolan Charles Normand Rose Anne Kenny Peter May |
| author_facet | Soraya Matthews Mark Ward Anne Nolan Charles Normand Rose Anne Kenny Peter May |
| author_sort | Soraya Matthews |
| collection | DOAJ |
| description | Abstract Objectives We aimed to replicate existing international (US and UK) mortality indices using Irish data. We developed and validated a four-year mortality index for adults aged 50 + in Ireland and compared performance with these international indices. We then extended this model by including additional predictors (self-report and healthcare utilization) and compared its performance to our replication model. Methods Eight thousand one hundred seventy-four participants in The Irish Longitudinal Study on Ageing were split for development (n = 4,121) and validation (n = 4,053). Six baseline predictor categories were examined (67 variables total): demographics; cardiovascular-related illness; non-cardiovascular illness; health and lifestyle variables; functional variables; self-report (wellbeing and social connectedness) and healthcare utilization. We identified variables independently associated with four-year mortality in the development cohort and attached these variables a weight according to strength of association. We summed the weights to calculate a single index score for each participant and evaluated predicted accuracy in the validation cohort. Results Our final 14-predictor (extended) model assigned risk points for: male (1pt); age (65–69: 2pts; 70–74: 4 pts; 75–79: 4pts; 80–84: 6pts; 85 + : 7pts); heart attack (1pt); cancer (3pts); smoked past age 30 (2pts); difficulty walking 100 m (2pts); difficulty using the toilet (3pts); difficulty lifting 10lbs (1pts); poor self-reported health (1pt); and hospital admission in previous year (1pt). Index discrimination was strong (ROC area = 0.78). Discussion Our index is predictive of four-year mortality in community-dwelling older Irish adults. Comparisons with the international indices show that our 12-predictor (replication) model performed well and suggests that generalisability is high. Our 14-predictor (extended) model showed modest improvements compared to the 12-predictor model. |
| first_indexed | 2024-04-13T17:11:33Z |
| format | Article |
| id | doaj.art-1c5aec33ed4b470abcce928ec4167aa6 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-13T17:11:33Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-1c5aec33ed4b470abcce928ec4167aa62022-12-22T02:38:16ZengBMCBMC Geriatrics1471-23182022-06-0122111110.1186/s12877-022-03196-zPredicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measuresSoraya Matthews0Mark Ward1Anne Nolan2Charles Normand3Rose Anne Kenny4Peter May5Centre for Health Policy and Management, Trinity College DublinThe Irish Longitudinal Study On Ageing, Trinity College DublinThe Irish Longitudinal Study On Ageing, Trinity College DublinCentre for Health Policy and Management, Trinity College DublinThe Irish Longitudinal Study On Ageing, Trinity College DublinCentre for Health Policy and Management, Trinity College DublinAbstract Objectives We aimed to replicate existing international (US and UK) mortality indices using Irish data. We developed and validated a four-year mortality index for adults aged 50 + in Ireland and compared performance with these international indices. We then extended this model by including additional predictors (self-report and healthcare utilization) and compared its performance to our replication model. Methods Eight thousand one hundred seventy-four participants in The Irish Longitudinal Study on Ageing were split for development (n = 4,121) and validation (n = 4,053). Six baseline predictor categories were examined (67 variables total): demographics; cardiovascular-related illness; non-cardiovascular illness; health and lifestyle variables; functional variables; self-report (wellbeing and social connectedness) and healthcare utilization. We identified variables independently associated with four-year mortality in the development cohort and attached these variables a weight according to strength of association. We summed the weights to calculate a single index score for each participant and evaluated predicted accuracy in the validation cohort. Results Our final 14-predictor (extended) model assigned risk points for: male (1pt); age (65–69: 2pts; 70–74: 4 pts; 75–79: 4pts; 80–84: 6pts; 85 + : 7pts); heart attack (1pt); cancer (3pts); smoked past age 30 (2pts); difficulty walking 100 m (2pts); difficulty using the toilet (3pts); difficulty lifting 10lbs (1pts); poor self-reported health (1pt); and hospital admission in previous year (1pt). Index discrimination was strong (ROC area = 0.78). Discussion Our index is predictive of four-year mortality in community-dwelling older Irish adults. Comparisons with the international indices show that our 12-predictor (replication) model performed well and suggests that generalisability is high. Our 14-predictor (extended) model showed modest improvements compared to the 12-predictor model.https://doi.org/10.1186/s12877-022-03196-zOlder peopleRisk factorsMortalityPrognosticationFrailty |
| spellingShingle | Soraya Matthews Mark Ward Anne Nolan Charles Normand Rose Anne Kenny Peter May Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures BMC Geriatrics Older people Risk factors Mortality Prognostication Frailty |
| title | Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures |
| title_full | Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures |
| title_fullStr | Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures |
| title_full_unstemmed | Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures |
| title_short | Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures |
| title_sort | predicting mortality in the irish longitudinal study on ageing tilda development of a four year index and comparison with international measures |
| topic | Older people Risk factors Mortality Prognostication Frailty |
| url | https://doi.org/10.1186/s12877-022-03196-z |
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