Mortality Risk Calculator for Community-Dwelling Older Adults with Dementia


Population: Community-dwelling older adults aged 65 years and older with dementia

Outcomes: All-cause 1, 2, 5, and 10-year mortality

Scroll to the bottom for more detailed information.

Risk Calculator
1. What is your patient's age?





2. What is your patient’s body mass index (BMI) category?



3. What is your patient’s biological sex?

4. Does your patient have difficulty with walking several blocks?

5. Does your patient participate in vigorous physical activity, such as running/jogging, swimming, cycling, aerobics or gym workout, tennis, or digging with a spade or shovel?

6. How many activities of daily living (ADL) dependencies does your patient have? ADL dependencies include needing help with dressing, bathing, eating, getting in or out of bed, and toileting (range 0-5).





7. How many instrumental activities of daily living (IADL) difficulties does your patient have? IADL difficulties include difficulty using a telephone, preparing a meal, managing medications, managing money such as paying bills, and shopping for groceries (range 0-5).





8. What is your patient’s smoking status?


9. Does your patient have a history of diabetes?

10. Does your patient have a history of heart disease?

11. Does your patient have a history of cancer, other than minor skin cancer?

12. Does your patient have a history of lung disease such as chronic obstructive pulmonary disease (COPD) or chronic bronchitis?



  • This index was developed in 4,267 community-dwelling individuals with dementia who were interviewed in the Health and Retirement study from 1998-2016 (mean age 82 years, 69% female, 12% Black).
  • Participants were classified as having dementia using a validated algorithm which has shown high accuracy in validation studies (e.g., AUC of 0.93 in training data and 0.84 in validation data).
  • Information on type of dementia was not available in the Health and Retirement Study.
  • Internal validation was performed via bootstrapping. External validation was performed in a cohort of community-dwelling older adults with dementia enrolled in the National Health and Aging Trends Study from 2011-2019 (N=2,404).

Discrimination: This risk calculator sorts patients who died earlier from patients who were still alive correctly 76% of the time (as measured by the integrated area under the receiver operating characteristic curve (iAUC) which is a weighted average of the AUC values at all event times). The time-specific AUC values after bootstrap internal validation in the HRS cohort were 0.73 at 1 year, 0.73 at 2 years, 0.75 at 5 years, and 0.84 at 10 years. Upon external validation in NHATS, the time-specific AUC values were 0.73 at 1 year, 0.73 at 2 years, and 0.74 at 5 years.

72%

Calibration: Calibration plots suggested good calibration across the range of predicted risk in both the HRS and NHATS cohorts.

Citation: Deardorff WJ, Barnes DE, Jeon SY, Boscardin WJ, Langa KM, Covinsky KE, Mitchell SL, Whitlock EL, Smith AK, Lee SJ. Development and external validation of a mortality prediction model for community-dwelling older adults with dementia. JAMA Intern Med. 2022;182(11):1161-1170. PMID 36156062.

DISCLAIMER

The information provided on ePrognosis is designed to complement, not replace, the relationship between a patient and his/her own medical providers. ePrognosis was created with the support of the Division of Geriatrics at the University of California San Francisco. However, its content is strictly the work of its authors and has no affiliation with any organization or institution. This web site does not accept advertisements. If you reproduce the material on the website please cite appropriately. For feedback and questions regarding the site please email Sei Lee, MD (sei.lee@ucsf.edu), Alex Smith, MD (aksmith@ucsf.edu) or Eric Widera, MD (eric.widera@ucsf.edu).