Prediction of disability-free survival in healthy older people

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....

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Main Authors:	Neumann, J.T., Thao, L.T.P., Murray, A.M., Callander, E., Carr, P.R., Nelson, M.R., Wolfe, R., Woods, R.L., Reid, Christopher, Shah, R.C., Newman, A.B., Williamson, J.D., Tonkin, A.M., McNeil, J.J., Murray, A., Beilin, L., Chan, A., Demons, J., Ernst, M., Espinoza, S., Goetz, M., Johnston, C., Kirpach, B., Liew, D., Margolis, K., Meyskens, F., Nelson, M., Reid, C., Shah, R., Storey, E., Woods, R., Zalcberg, J., Ives, D., Berk, M., Bernstein, W., Brauer, D., Burns, C., Chong, T., Cloud, G., Donnan, G., Eaton, C., Fitzgerald, P., Gibbs, P., Haydon, A., Jelinek, M., Macrae, F., Mahady, S., Malik, M., McLean, C., Newman, A., Rodriguez, L., Satterfield, S., van Londen, G., Ward, S., Williamson, J., Wood, E., Mohr, J., Anderson, G., Connolly, S., Friedman, L., Manson, J.A., Sano, M., Morrison, S., Ohman, E.M., Abhayaratna, W., Lockett, T., Stocks, N., Lewis, B., Obisesan, T., Gilbertson, D., Lockery, J., Rigby, J.
Format:	Journal Article
Language:	English
Published:	SPRINGER 2022
Subjects:	Science & Technology Life Sciences & Biomedicine Geriatrics & Gerontology Risk prediction Disability Survival Elderly Healthy Public Health RISK-FACTORS LIFE EPIDEMIOLOGY LONGEVITY MOBILITY ADULTS Aged Aspirin Australia Female Healthy Aging Healthy Life Expectancy Humans Male Risk Factors ASPREE investigators
Online Access:	http://purl.org/au-research/grants/nhmrc/334047 http://hdl.handle.net/20.500.11937/93101

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author	Neumann, J.T. Thao, L.T.P. Murray, A.M. Callander, E. Carr, P.R. Nelson, M.R. Wolfe, R. Woods, R.L. Reid, Christopher Shah, R.C. Newman, A.B. Williamson, J.D. Tonkin, A.M. McNeil, J.J. Murray, A. Beilin, L. Chan, A. Demons, J. Ernst, M. Espinoza, S. Goetz, M. Johnston, C. Kirpach, B. Liew, D. Margolis, K. Meyskens, F. Nelson, M. Reid, C. Shah, R. Storey, E. Woods, R. Zalcberg, J. Nelson, M. Ives, D. Berk, M. Bernstein, W. Brauer, D. Burns, C. Chong, T. Cloud, G. Donnan, G. Eaton, C. Fitzgerald, P. Gibbs, P. Haydon, A. Jelinek, M. Macrae, F. Mahady, S. Malik, M. McLean, C. Murray, A. Newman, A. Rodriguez, L. Satterfield, S. Shah, R. van Londen, G. Ward, S. Williamson, J. Wood, E. Zalcberg, J. Mohr, J. Anderson, G. Connolly, S. Friedman, L. Manson, J.A. Sano, M. Morrison, S. Ohman, E.M. Woods, R. Abhayaratna, W. Donnan, G. Johnston, C. Lockett, T. Nelson, M. Reid, C. Stocks, N. Murray, A. Reid, C. Ernst, M. Johnston, C. Lewis, B. Nelson, M. Newman, A. Obisesan, T. Shah, R. Woods, R. Reid, C. Ernst, M. Gilbertson, D. Shah, R. Woods, R. Lockery, J. Rigby, J.
author_facet	Neumann, J.T. Thao, L.T.P. Murray, A.M. Callander, E. Carr, P.R. Nelson, M.R. Wolfe, R. Woods, R.L. Reid, Christopher Shah, R.C. Newman, A.B. Williamson, J.D. Tonkin, A.M. McNeil, J.J. Murray, A. Beilin, L. Chan, A. Demons, J. Ernst, M. Espinoza, S. Goetz, M. Johnston, C. Kirpach, B. Liew, D. Margolis, K. Meyskens, F. Nelson, M. Reid, C. Shah, R. Storey, E. Woods, R. Zalcberg, J. Nelson, M. Ives, D. Berk, M. Bernstein, W. Brauer, D. Burns, C. Chong, T. Cloud, G. Donnan, G. Eaton, C. Fitzgerald, P. Gibbs, P. Haydon, A. Jelinek, M. Macrae, F. Mahady, S. Malik, M. McLean, C. Murray, A. Newman, A. Rodriguez, L. Satterfield, S. Shah, R. van Londen, G. Ward, S. Williamson, J. Wood, E. Zalcberg, J. Mohr, J. Anderson, G. Connolly, S. Friedman, L. Manson, J.A. Sano, M. Morrison, S. Ohman, E.M. Woods, R. Abhayaratna, W. Donnan, G. Johnston, C. Lockett, T. Nelson, M. Reid, C. Stocks, N. Murray, A. Reid, C. Ernst, M. Johnston, C. Lewis, B. Nelson, M. Newman, A. Obisesan, T. Shah, R. Woods, R. Reid, C. Ernst, M. Gilbertson, D. Shah, R. Woods, R. Lockery, J. Rigby, J.
author_sort	Neumann, J.T.
building	Curtin Institutional Repository
collection	Online Access
description	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).
first_indexed	2025-11-14T11:39:23Z
format	Journal Article
id	curtin-20.500.11937-93101
institution	Curtin University Malaysia
institution_category	Local University
language	English
last_indexed	2025-11-14T11:39:23Z
publishDate	2022
publisher	SPRINGER
recordtype	eprints
repository_type	Digital Repository
spelling	curtin-20.500.11937-931012023-09-18T01:45:54Z Prediction of disability-free survival in healthy older people Neumann, J.T. Thao, L.T.P. Murray, A.M. Callander, E. Carr, P.R. Nelson, M.R. Wolfe, R. Woods, R.L. Reid, Christopher Shah, R.C. Newman, A.B. Williamson, J.D. Tonkin, A.M. McNeil, J.J. Murray, A. Beilin, L. Chan, A. Demons, J. Ernst, M. Espinoza, S. Goetz, M. Johnston, C. Kirpach, B. Liew, D. Margolis, K. Meyskens, F. Nelson, M. Reid, C. Shah, R. Storey, E. Woods, R. Zalcberg, J. Nelson, M. Ives, D. Berk, M. Bernstein, W. Brauer, D. Burns, C. Chong, T. Cloud, G. Donnan, G. Eaton, C. Fitzgerald, P. Gibbs, P. Haydon, A. Jelinek, M. Macrae, F. Mahady, S. Malik, M. McLean, C. Murray, A. Newman, A. Rodriguez, L. Satterfield, S. Shah, R. van Londen, G. Ward, S. Williamson, J. Wood, E. Zalcberg, J. Mohr, J. Anderson, G. Connolly, S. Friedman, L. Manson, J.A. Sano, M. Morrison, S. Ohman, E.M. Woods, R. Abhayaratna, W. Donnan, G. Johnston, C. Lockett, T. Nelson, M. Reid, C. Stocks, N. Murray, A. Reid, C. Ernst, M. Johnston, C. Lewis, B. Nelson, M. Newman, A. Obisesan, T. Shah, R. Woods, R. Reid, C. Ernst, M. Gilbertson, D. Shah, R. Woods, R. Lockery, J. Rigby, J. Science & Technology Life Sciences & Biomedicine Geriatrics & Gerontology Risk prediction Disability Survival Elderly Healthy Public Health RISK-FACTORS LIFE EPIDEMIOLOGY LONGEVITY MOBILITY ADULTS Disability Elderly Healthy Public Health Risk prediction Survival Aged Aspirin Australia Female Healthy Aging Healthy Life Expectancy Humans Male Risk Factors ASPREE investigators Humans Aspirin Risk Factors Aged Australia Female Male Healthy Aging Healthy Life Expectancy 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). 2022 Journal Article http://hdl.handle.net/20.500.11937/93101 10.1007/s11357-022-00547-x English http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/1127060 http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1173690 http://creativecommons.org/licenses/by/4.0/ SPRINGER fulltext
spellingShingle	Science & Technology Life Sciences & Biomedicine Geriatrics & Gerontology Risk prediction Disability Survival Elderly Healthy Public Health RISK-FACTORS LIFE EPIDEMIOLOGY LONGEVITY MOBILITY ADULTS Disability Elderly Healthy Public Health Risk prediction Survival Aged Aspirin Australia Female Healthy Aging Healthy Life Expectancy Humans Male Risk Factors ASPREE investigators Humans Aspirin Risk Factors Aged Australia Female Male Healthy Aging Healthy Life Expectancy Neumann, J.T. Thao, L.T.P. Murray, A.M. Callander, E. Carr, P.R. Nelson, M.R. Wolfe, R. Woods, R.L. Reid, Christopher Shah, R.C. Newman, A.B. Williamson, J.D. Tonkin, A.M. McNeil, J.J. Murray, A. Beilin, L. Chan, A. Demons, J. Ernst, M. Espinoza, S. Goetz, M. Johnston, C. Kirpach, B. Liew, D. Margolis, K. Meyskens, F. Nelson, M. Reid, C. Shah, R. Storey, E. Woods, R. Zalcberg, J. Nelson, M. Ives, D. Berk, M. Bernstein, W. Brauer, D. Burns, C. Chong, T. Cloud, G. Donnan, G. Eaton, C. Fitzgerald, P. Gibbs, P. Haydon, A. Jelinek, M. Macrae, F. Mahady, S. Malik, M. McLean, C. Murray, A. Newman, A. Rodriguez, L. Satterfield, S. Shah, R. van Londen, G. Ward, S. Williamson, J. Wood, E. Zalcberg, J. Mohr, J. Anderson, G. Connolly, S. Friedman, L. Manson, J.A. Sano, M. Morrison, S. Ohman, E.M. Woods, R. Abhayaratna, W. Donnan, G. Johnston, C. Lockett, T. Nelson, M. Reid, C. Stocks, N. Murray, A. Reid, C. Ernst, M. Johnston, C. Lewis, B. Nelson, M. Newman, A. Obisesan, T. Shah, R. Woods, R. Reid, C. Ernst, M. Gilbertson, D. Shah, R. Woods, R. Lockery, J. Rigby, J. Prediction of disability-free survival in healthy older people
title	Prediction of disability-free survival in healthy older people
title_full	Prediction of disability-free survival in healthy older people
title_fullStr	Prediction of disability-free survival in healthy older people
title_full_unstemmed	Prediction of disability-free survival in healthy older people
title_short	Prediction of disability-free survival in healthy older people
title_sort	prediction of disability-free survival in healthy older people
topic	Science & Technology Life Sciences & Biomedicine Geriatrics & Gerontology Risk prediction Disability Survival Elderly Healthy Public Health RISK-FACTORS LIFE EPIDEMIOLOGY LONGEVITY MOBILITY ADULTS Disability Elderly Healthy Public Health Risk prediction Survival Aged Aspirin Australia Female Healthy Aging Healthy Life Expectancy Humans Male Risk Factors ASPREE investigators Humans Aspirin Risk Factors Aged Australia Female Male Healthy Aging Healthy Life Expectancy
url	http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://hdl.handle.net/20.500.11937/93101

Prediction of disability-free survival in healthy older people

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