Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Abstract

This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005)(2006)(2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of mortality included in the final model (p<0.05) were older age, body mass index<20 kg m 2 , high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong nondrinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it AGE (2014) was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a younger population, including high blood pressure, hypercholesterolaemia, overweight and obesity and diabetes, were not independent predictors of mortality in this population of older men.

Mortality is associated with inflammation, anemia, specific diseases and treatments, and molecular markers

“…This also holds true for some of the other studies [4], [6]. Then again, we obtained results similar to [10], who evaluated a similar set of variables as we did in a study of men aged 70 and older, also highlighting smoking, anemia and albumin.…”

Distinct Physical Function Profiles in Older Adults Receiving Cancer Chemotherapy

“…This problem is important to evaluate in older adults because anemia is associated with decreased physical performance, 57 an increase in the number of falls, 58 frailty, 57,59,60 increase in depressive symptoms, 61,62 increase in the number of hospitalizations, 63 and increased mortality. 64,65 While the level of anemia observed in this study may not warrant routine treatment in oncology patients, clinicians need to monitor older adults receiving CTX more carefully to evaluate the impact of anemia on their ability to function.…”

Moderately Reduced Estimated Glomerular Filtration Rate (eGFR) among Community - Dwelling Older People Associated with Increased Long Term Mortality: A Study from Low to Middle Income Country in Asia.

“…The present study demonstrates CKD to be an important risk factor for increased mortality among older people, and the strongest association with mortality is among patients with advanced-stage CKD. Three studies have explored the effect of CKD on mortality among community-dwelling older people (24)(25)(26) , and all of those studies were conducted in high income countries. CKD was identi ed as an independent risk factor for mortality in two of those studies (24,26) , but not in the one other study (25) .…”