| アブストラクト | BACKGROUND: Functional and cognitive domains have rarely been evaluated for their prognostic value in general practice databases. The aim of this study was to identify functional and cognitive domains in The Health Improvement Network (THIN) and to evaluate their additional value for the prediction of 1-month and 1-year mortality in elderly people. MATERIALS AND METHODS: A cohort study was conducted using a UK nationwide general practitioner database. A total of 1,193,268 patients aged 65 years or older, of whom 15,300 had dementia, were identified from 2000 to 2012. Information on mobility, dressing and accommodation was recorded frequently enough to be analyzed further in THIN. Cognition data could not be used due to very poor recording of data in THIN. One-year and 1-month mortality was predicted using logistic models containing variables such as age, sex, disease score and functionality status. RESULTS: A significant but moderate improvement in 1-year and 1-month mortality prediction in elderly people was observed by adding accommodation to the variables age, sex and disease score, as the c-statistic (95% confidence interval [CI]) increased from 0.71 (0.70-0.72) to 0.76 (0.75-0.77) and 0.73 (0.71-0.75) to 0.79 (0.77-0.80), respectively. A less notable improvement in the prediction of 1-year and 1-month mortality was observed in people with dementia. CONCLUSION: Functional domains moderately improved the accuracy of a model including age, sex and comorbidities in predicting 1-year and 1-month mortality risk among community-dwelling older people, but they were much less able to predict mortality in people with dementia. Cognition could not be explored as a predictor of mortality due to insufficient data being recorded. |
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| ジャーナル名 | Clinical epidemiology |
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| Pubmed追加日 | 2018/1/4 |
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| 投稿者 | Sultana, Janet; Fontana, Andrea; Giorgianni, Francesco; Basile, Giorgio; Patorno, Elisabetta; Pilotto, Alberto; Molokhia, Mariam; Stewart, Robert; Sturkenboom, Miriam; Trifiro, Gianluca |
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| 組織名 | Department of Biomedical and Dental Sciences and Morphofunctional Imaging,;University of Messina, Messina, Italy.;Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam,;the Netherlands.;Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni;Rotondo, Italy.;Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine,;Brigham and Women's Hospital and Harvard Medical School, Boston, USA.;Geriatrics Unit, Department of Geriatric Care, Ortho Geriatrics and;Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy.;Department of Primary Care and Public Health Sciences, King's College, London,;UK.;Department of Psychological Medicine, Institute of Psychiatry, Psychology and;Neuroscience King's College London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/29296099/ |
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