Development and validation of a 10-year mortality prediction model: Meta-analysis of individual participant data from five cohorts of older adults in developed and developing countries

Claudia Kimie Suemoto, Peter Ueda, Hiram Beltrán-Sánchez, Maria Lucia Lebrão, Yeda Aparecida Duarte, Rebeca Wong, Goodarz Danaei

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Background: Existing mortality prediction models for older adults have been each developed using a single study from the United States or Western Europe. We aimed to develop and validate a 10-year mortality prediction model for older adults using data from developed and developing countries. Methods: We used data from five cohorts, including data from 16 developed and developing countries: ELSA (English Longitudinal Study of Aging), HRS (Health and Retirement Study), MHAS (Mexican Health and Aging Study), SABE-Sao Paulo (The Health, Well-being and Aging), and SHARE (Survey on Health, Ageing and Retirement in Europe). 35,367 older adults were split into training (two thirds) and test (one third) data sets. Baseline predictors included age, sex, comorbidities, and functional and cognitive measures. We performed an individual participant data meta-analysis using a sex-stratified Cox proportional hazards model, with time to death as the time scale. We validated the model using Harrell's C statistic (discrimination) and the estimated slope between observed and predicted 10-year mortality risk across deciles of risk (calibration). Results: During a median of 8.6 years, 8,325 participants died. The final model included age, sex, diabetes, heart disease, lung disease, cancer, smoking, alcohol use, body mass index, physical activity, self-reported health, difficulty with bathing, walking several blocks, and reporting date correctly. The model showed good discrimination (Harrell's C = 0.76) and calibration (slope = 1.005). Models for developed versus developing country cohorts performed equally well when applied to data from developing countries. Conclusion: A parsimonious mortality prediction model using data from multiple cohorts in developed and developing countries can be used to predict mortality in older adults in both settings.

Original languageEnglish (US)
Pages (from-to)410-416
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume72
Issue number3
DOIs
StatePublished - 2016
Externally publishedYes

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Keywords

  • Mortality
  • Older adults
  • Prediction models
  • Prevention

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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