Prediction of disability-free survival in healthy older people

Johannes Tobias Neumann; Le T P Thao; Anne M Murray; Emily Callander; Prudence R Carr; Mark R Nelson; Rory Wolfe; Robyn L Woods; Christopher M Reid; Raj C Shah; Anne B Newman; Jeff D Williamson; Andrew M Tonkin; John J McNeil; ASPREE investigators

doi:10.1007/s11357-022-00547-x

Prediction of disability-free survival in healthy older people

Standard

Prediction of disability-free survival in healthy older people. / Neumann, Johannes Tobias; Thao, Le T P; Murray, Anne M; Callander, Emily; Carr, Prudence R; Nelson, Mark R; Wolfe, Rory; Woods, Robyn L; Reid, Christopher M; Shah, Raj C; Newman, Anne B; Williamson, Jeff D; Tonkin, Andrew M; McNeil, John J; ASPREE investigators.

In: GEROSCIENCE, Vol. 44, No. 3, 06.2022, p. 1641-1655.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Neumann, JT, Thao, LTP, Murray, AM, Callander, E, Carr, PR, Nelson, MR, Wolfe, R, Woods, RL, Reid, CM, Shah, RC, Newman, AB, Williamson, JD, Tonkin, AM, McNeil, JJ & ASPREE investigators 2022, 'Prediction of disability-free survival in healthy older people', GEROSCIENCE, vol. 44, no. 3, pp. 1641-1655. https://doi.org/10.1007/s11357-022-00547-x

APA

Neumann, J. T., Thao, L. T. P., Murray, A. M., Callander, E., Carr, P. R., Nelson, M. R., Wolfe, R., Woods, R. L., Reid, C. M., Shah, R. C., Newman, A. B., Williamson, J. D., Tonkin, A. M., McNeil, J. J., & ASPREE investigators (2022). Prediction of disability-free survival in healthy older people. GEROSCIENCE, 44(3), 1641-1655. https://doi.org/10.1007/s11357-022-00547-x

Vancouver

Neumann JT, Thao LTP, Murray AM, Callander E, Carr PR, Nelson MR et al. Prediction of disability-free survival in healthy older people. GEROSCIENCE. 2022 Jun;44(3):1641-1655. https://doi.org/10.1007/s11357-022-00547-x

Bibtex

@article{d792f93366af47e8b53cb6aca4f6f28f,

title = "Prediction of disability-free survival in healthy older people",

abstract = "Prolonging survival in good health is a fundamental societal goal. However, the leading determinants of disability-free survival in healthy older people have not been well established. Data from ASPREE, a bi-national placebo-controlled trial of aspirin with 4.7 years median follow-up, was analysed. At enrolment, participants were healthy and without prior cardiovascular events, dementia or persistent physical disability. Disability-free survival outcome was defined as absence of dementia, persistent disability or death. Selection of potential predictors from amongst 25 biomedical, psychosocial and lifestyle variables including recognized geriatric risk factors, utilizing a machine-learning approach. Separate models were developed for men and women. The selected predictors were evaluated in a multivariable Cox proportional hazards model and validated internally by bootstrapping. We included 19,114 Australian and US participants aged ≥65 years (median 74 years, IQR 71.6-77.7). Common predictors of a worse prognosis in both sexes included higher age, lower Modified Mini-Mental State Examination score, lower gait speed, lower grip strength and abnormal (low or elevated) body mass index. Additional risk factors for men included current smoking, and abnormal eGFR. In women, diabetes and depression were additional predictors. The biased-corrected areas under the receiver operating characteristic curves for the final prognostic models at 5 years were 0.72 for men and 0.75 for women. Final models showed good calibration between the observed and predicted risks. We developed a prediction model in which age, cognitive function and gait speed were the strongest predictors of disability-free survival in healthy older people.Trial registration Clinicaltrials.gov (NCT01038583).",

keywords = "Aged, Aspirin, Australia, Female, Healthy Aging, Healthy Life Expectancy, Humans, Male, Risk Factors",

author = "Neumann, {Johannes Tobias} and Thao, {Le T P} and Murray, {Anne M} and Emily Callander and Carr, {Prudence R} and Nelson, {Mark R} and Rory Wolfe and Woods, {Robyn L} and Reid, {Christopher M} and Shah, {Raj C} and Newman, {Anne B} and Williamson, {Jeff D} and Tonkin, {Andrew M} and McNeil, {John J} and {ASPREE investigators}",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = jun,

doi = "10.1007/s11357-022-00547-x",

language = "English",

volume = "44",

pages = "1641--1655",

journal = "GEROSCIENCE",

issn = "2509-2715",

publisher = "Springer International Publishing",

number = "3",

}

RIS

TY - JOUR

T1 - Prediction of disability-free survival in healthy older people

AU - Neumann, Johannes Tobias

AU - Thao, Le T P

AU - Murray, Anne M

AU - Callander, Emily

AU - Carr, Prudence R

AU - Nelson, Mark R

AU - Wolfe, Rory

AU - Woods, Robyn L

AU - Reid, Christopher M

AU - Shah, Raj C

AU - Newman, Anne B

AU - Williamson, Jeff D

AU - Tonkin, Andrew M

AU - McNeil, John J

AU - ASPREE investigators

PY - 2022/6

Y1 - 2022/6

N2 - Prolonging survival in good health is a fundamental societal goal. However, the leading determinants of disability-free survival in healthy older people have not been well established. Data from ASPREE, a bi-national placebo-controlled trial of aspirin with 4.7 years median follow-up, was analysed. At enrolment, participants were healthy and without prior cardiovascular events, dementia or persistent physical disability. Disability-free survival outcome was defined as absence of dementia, persistent disability or death. Selection of potential predictors from amongst 25 biomedical, psychosocial and lifestyle variables including recognized geriatric risk factors, utilizing a machine-learning approach. Separate models were developed for men and women. The selected predictors were evaluated in a multivariable Cox proportional hazards model and validated internally by bootstrapping. We included 19,114 Australian and US participants aged ≥65 years (median 74 years, IQR 71.6-77.7). Common predictors of a worse prognosis in both sexes included higher age, lower Modified Mini-Mental State Examination score, lower gait speed, lower grip strength and abnormal (low or elevated) body mass index. Additional risk factors for men included current smoking, and abnormal eGFR. In women, diabetes and depression were additional predictors. The biased-corrected areas under the receiver operating characteristic curves for the final prognostic models at 5 years were 0.72 for men and 0.75 for women. Final models showed good calibration between the observed and predicted risks. We developed a prediction model in which age, cognitive function and gait speed were the strongest predictors of disability-free survival in healthy older people.Trial registration Clinicaltrials.gov (NCT01038583).

AB - Prolonging survival in good health is a fundamental societal goal. However, the leading determinants of disability-free survival in healthy older people have not been well established. Data from ASPREE, a bi-national placebo-controlled trial of aspirin with 4.7 years median follow-up, was analysed. At enrolment, participants were healthy and without prior cardiovascular events, dementia or persistent physical disability. Disability-free survival outcome was defined as absence of dementia, persistent disability or death. Selection of potential predictors from amongst 25 biomedical, psychosocial and lifestyle variables including recognized geriatric risk factors, utilizing a machine-learning approach. Separate models were developed for men and women. The selected predictors were evaluated in a multivariable Cox proportional hazards model and validated internally by bootstrapping. We included 19,114 Australian and US participants aged ≥65 years (median 74 years, IQR 71.6-77.7). Common predictors of a worse prognosis in both sexes included higher age, lower Modified Mini-Mental State Examination score, lower gait speed, lower grip strength and abnormal (low or elevated) body mass index. Additional risk factors for men included current smoking, and abnormal eGFR. In women, diabetes and depression were additional predictors. The biased-corrected areas under the receiver operating characteristic curves for the final prognostic models at 5 years were 0.72 for men and 0.75 for women. Final models showed good calibration between the observed and predicted risks. We developed a prediction model in which age, cognitive function and gait speed were the strongest predictors of disability-free survival in healthy older people.Trial registration Clinicaltrials.gov (NCT01038583).

KW - Aged

KW - Aspirin

KW - Australia

KW - Female

KW - Healthy Aging

KW - Healthy Life Expectancy

KW - Humans

KW - Male

KW - Risk Factors

U2 - 10.1007/s11357-022-00547-x

DO - 10.1007/s11357-022-00547-x

M3 - SCORING: Journal article

C2 - 35420334

VL - 44

SP - 1641

EP - 1655

JO - GEROSCIENCE

JF - GEROSCIENCE

SN - 2509-2715

IS - 3

ER -