12-question quiz predicts your odds of dying within the next four years
by Sharon Kirkey
Want to take a test to predict your odds of dying within the next four years that is 81 per cent accurate?
Researchers at the San Francisco Veterans Affairs Medical Centre have developed an easy-to-use mortality risk test based on a 12-question quiz that predicts the likelihood of dying within four years for people 50 and older.
It takes just minutes to fill out, with no need for blood tests, CAT scans or a review of your medical records.
Instead, the “prognostic index,” published today in the Journal of the American Medical Association, assigns points to different risk factors for a limited life expectancy: not being able to walk several blocks costs as many points as having cancer or heart failure. Are you male? Add two points – and in this game, scoring points is not a good thing. Can’t push or pull a living room chair? One point.
Surprisingly, and controversially, having a body mass index (BMI) of 25 – the “overweight” category – seemed to be protective, as long as you don’t have diabetes. On the other hand, a BMI less than 25 was associated with a shorter life expectancy…
“This should not be interpreted as saying obesity is not harmful,” stressed senior author Kevin Covinsky, associate professor of medicine at the University of California, San Francisco.
“This might just reflect what’s an appropriate BMI in older vs. younger people.”
And not everything that lowers life expectancy, such as cholesterol levels, was included.
“There could be reasons that someone could do better or worse than what’s calculated by the index,” said Covinsky, a staff physician at the VA Medical Centre.
The test is fortuitous; it’s publication comes just one day after a report showing baby boomers are lumbering toward record heart attack and stroke rates. Obesity rates among boomers have increased by nearly 60 per cent compared to 10 years ago, 52 per cent of the post-war demographic is inactive, but 80 per cent believe they’ll live longer than their parents.
The new death risk test was derived from data collected from 11,701 U.S. citizens age 50 and older who were interviewed in 1998 as part of a health and retirement survey.
Interviewers collected information about sex and age, such diseases as hypertension, diabetes, chronic lung disease and heart failure, and whether people had trouble with activities of normal daily living – bathing, dressing, walking across a room, even picking a dime off the floor.
The researchers then looked to see who had died by Dec. 31, 2002, to determine how well the different “variables” had predicted their death.
In the end, they identified 12 predictors of mortality and assigned points to each.
“An important finding to us is that very common measures of whether somebody has difficulty doing day-to-day tasks are pretty much as important as what diseases one has,” Covinsky said.
A patient who scores zero to five has a less than four per cent risk of dying within four years, according to the test. A score of six to nine points predicts a 15-per-cent risk of death, 10 to 13 a 42-per-cent risk and 14 or more points a 64-per-cent risk of dying within four years.
Predicting a person’s “near-term likelihood of death” could help when deciding about medical tests or treatments, said lead author Sei Lee, a geriatric specialist at the VA Medical Centre.
For example, it might not be worth it to order a Pap smear or colonoscopy if the person is not likely to survive long enough to benefit, Lee said in a news release made public with the study. “Those sorts of screening interventions generally don’t help patients until five to eight years after they are given.”
But the test could help doctors identify high-risk patients so that specific interventions could be targeted to them.
It’s probably not useful for younger people, however, because four-year mortality is already low in people younger than 50, Covinsky says.
Points that you don’t want to be racking up
This test, developed by researchers at the San Francisco Veterans Affairs Medical Centre, tries to calculate the risk
of death within four years for people 50 and older.
1. Age: 60-64 years old, 1 point; 65-69, 2 points; 70-74 ,
3 points; 75-79, 4 points; 80-84, 5 points; 85 and older,
7 points.
2. Male or Female: Male 2 points.
3. Body-mass index: Less than 25 (normal weight or less)
1 point. (Calculate by multiplying height in inches times height in inches; then divide weight in pounds by that total; then multiply the total by 703.)
4. Diabetes: 2 points.
5. Cancer (excluding minor skin cancers): 2 points.
6. Chronic lung disease that limits activities or requires
oxygen use at home: 2 points.
7. Congestive heart failure: 2 points.
8. Cigarette smoking in the past week: 2 points.
9. Difficulty bathing/showering because of a health or memory problem: 2 points.
10. Difficulty managing money, paying bills, keeping track of expenses because of a health or memory problem: 2 points.
11. Difficulty walking several blocks because of a health problem: 2 points.
12. Difficulty pushing or pulling large objects like a living-room chair because of a health problem: 1 point.
Score: 0 to 5 points, less than a four per cent risk of dying; 6-9 points, 15 per cent risk; 10-13 points, 42 per cent risk; 14 or more points, 64 per cent risk.
Note: Researchers say the one-point penalty for having
a body-mass index under 25 (normal weight or less) is based on findings that being underweight is a health risk for elderly people.
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