Good health in old age is not enough! Better measures of mortality risk!
"... For the study, the team analyzed information from 8,250 adults aged 65 and older. Within four years of a baseline interview, 22 percent had died. Prediction methods with a machine-learning tool called LASSO drew from 183 possible social predictors to reveal eight that predicted death within four years: poor neighborhood cleanliness, low perceived control over financial situation, meeting with children less than yearly, not working for pay, not active with children, not volunteering, feeling isolated, and being treated with less courtesy or respect. ..."
From the significance and abstract:
"Significance
While it is well established that social attributes predict mortality, mortality prediction models used in clinical, population health, and research settings rely almost exclusively on demographics and medical comorbidities. In this study of 8,250 older adults from the Health and Retirement Study, we develop and validate a parsimonious index of Social Frailty, which uses age, gender, and eight social characteristics to predict 4-y mortality risk. We demonstrate that this prognostic index accurately risk-stratifies older adults and improves the prediction of commonly used comorbidity- and function-based risk models.
Abstract
... Lacking an efficient way to summarize the prognostic impact of social factor, many studies exclude social factors altogether. Our objective was to develop and validate a summary measure of social risk and determine its ability to risk-stratify beyond traditional risk models. We examined participants in the Health and Retirement Study, a longitudinal, survey of US older adults. We developed the model from a comprehensive inventory of 183 social characteristics using least absolute shrinkage and selection operator, a penalized regression approach. Then, we assessed the predictive capacity of the model and its ability to improve on traditional prediction models. We studied 8,250 adults aged ≥65 y. Within 4 y of the baseline interview, 22% had died. Drawn from 183 possible predictors, the Social Frailty Index included age, gender, and eight social predictors: neighborhood cleanliness, perceived control over financial situation, meeting with children less than yearly, not working for pay, active with children, volunteering, feeling isolated, and being treated with less courtesy or respect. In the validation cohort, predicted and observed mortality were strongly correlated. Additionally, the Social Frailty Index meaningfully risk-stratified participants beyond the Charlson score (medical comorbidity index) and the Lee Index (comorbidity and function model). ..."
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