BACKGROUND
The Vulnerable Elders-13 Survey (VES-13) is a short tool that predicts functional decline and mortality over a 1–2 year follow-up interval. Prognosis over longer intervals is often needed in clinical care.
OBJECTIVE
To test the predictive properties of the VES-13 over a 5-year interval.
DESIGN
Longitudinal evaluation with mean follow-up of 4.5 years.
SETTING
Two managed-care organizations.
PARTICIPANTS
649 community-dwelling elders (age ≥75 and older) enrolled in the Assessing Care of Vulnerable Elders (ACOVE) observational study who screened positively for symptoms of fear of falling/falls, bothersome urinary incontinence, or memory problems.
MEASUREMENTS
VES-13 score (range 1–10, higher indicates worse prognosis); functional decline (defined as decline in count of 5 activities of daily living or nursing home entry); deaths.
RESULTS
Greater VES-13 scores are associated with greater predicted probability of death and decline among older patients over a mean observation period of 4.5 years. For each additional VES-13 point, the odds of the combined outcome of functional decline or death was 1.37 (95% CI 1.25–1.50), and the area under the receiver operating curve (AUC) was 0.75 (95% CI .71–.80). In the Cox proportional hazards model predicting time to death, the hazard ratio was 1.23 (95% CI 1.19–1.27) per additional VES-13 point.
CONCLUSION
This study extends the utility of the VES-13 to clinical decisions that require longer-term prognostic estimates of functional status and survival.
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