Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study

Abstract Background Assessment the impact of disability on mortality among the elderly is vital to healthy ageing. The present study aimed to assess the long-term influence of disability on death in the elderly based on a longitudinal study. Method This study used the Chinese Longitudinal Healthy Lo...

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Autores principales:	Yang Yang, Zhaohui Du, Yafei Liu, Jiahui Lao, Xiaoru Sun, Fang Tang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Disability Elderly Cohort study Death Cox proportional hazards model Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/b67bf538d86241a4bcdcafbc609d58f6
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spelling	oai:doaj.org-article:b67bf538d86241a4bcdcafbc609d58f62021-11-28T12:08:59ZDisability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study10.1186/s12877-021-02611-11471-2318https://doaj.org/article/b67bf538d86241a4bcdcafbc609d58f62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12877-021-02611-1https://doaj.org/toc/1471-2318Abstract Background Assessment the impact of disability on mortality among the elderly is vital to healthy ageing. The present study aimed to assess the long-term influence of disability on death in the elderly based on a longitudinal study. Method This study used the Chinese Longitudinal Healthy Longevity Study (CLHLS) data from 2002 to 2014, including 13,666 participants aged 65 years and older in analyses. The Katz ADL index was used to assess disability status and levels. Cumulative mortality rates were estimated by the Kaplan-Meier method. Cox proportional hazards models were conducted to estimate associations between disability and all-cause mortality for overall participants, two age groups as well as specific chronic disease groups. All reported results were adjusted by survey weights to account for the complex survey design. Results During the 12-year follow-up, the death density was 6.01 per 100 person-years. The 3-years’ cumulative mortality rate of nondisabled elderly was 11.9% (95%CI: 10.9, 12.9%). As the level of disability increased, the cumulative mortality rate was from 28.1% (95%CI: 23.0, 33.1%) to 77.6% (95%CI: 63.8, 91.4%). Compared with non-disabled elderly, the multiple-adjusted hazard ratio of death due to disability was 1.68 (95% CI: 1.48, 1.90). The hazard ratios varied from 1.44 (95%CI: 1.23, 1.67) to 4.45 (95%CI: 2.69, 7.38) after classifying the disability levels. The hazard ratios of death in the young-old group (65–79 years) were higher than the old-old group (80 years and over) in both level B (HR = 1.58, 95%CI: 1.25, 2.00 vs. HR = 1.22, 95%CI: 1.06, 1.39, P = 0.029) and level G (HR = 24.09, 95%CI: 10.83, 53.60 vs. HR = 2.56, 95%CI: 1.75, 3.74, P < 0.001). For patients with hypertension, diabetes, heart disease, cerebrovascular disease as well as dementia, disability increases their relative risk of mortality by 1.64 (95%CI: 1.40, 1.93), 2.85 (95%CI: 1.46, 5.58), 1.45 (95%CI: 1.02, 2.05), 2.13 (95%CI: 1.54, 2.93) and 3.56 (95%CI: 1.22, 10.38) times, respectively. Conclusions Disability increases the risk of all-cause death in the elderly, especially those with chronic diseases and the young-old group. Further studies are needed to better understand how to effectively prevent disability in the older population.Yang YangZhaohui DuYafei LiuJiahui LaoXiaoru SunFang TangBMCarticleDisabilityElderlyCohort studyDeathCox proportional hazards modelGeriatricsRC952-954.6ENBMC Geriatrics, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Disability Elderly Cohort study Death Cox proportional hazards model Geriatrics RC952-954.6
spellingShingle	Disability Elderly Cohort study Death Cox proportional hazards model Geriatrics RC952-954.6 Yang Yang Zhaohui Du Yafei Liu Jiahui Lao Xiaoru Sun Fang Tang Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
description	Abstract Background Assessment the impact of disability on mortality among the elderly is vital to healthy ageing. The present study aimed to assess the long-term influence of disability on death in the elderly based on a longitudinal study. Method This study used the Chinese Longitudinal Healthy Longevity Study (CLHLS) data from 2002 to 2014, including 13,666 participants aged 65 years and older in analyses. The Katz ADL index was used to assess disability status and levels. Cumulative mortality rates were estimated by the Kaplan-Meier method. Cox proportional hazards models were conducted to estimate associations between disability and all-cause mortality for overall participants, two age groups as well as specific chronic disease groups. All reported results were adjusted by survey weights to account for the complex survey design. Results During the 12-year follow-up, the death density was 6.01 per 100 person-years. The 3-years’ cumulative mortality rate of nondisabled elderly was 11.9% (95%CI: 10.9, 12.9%). As the level of disability increased, the cumulative mortality rate was from 28.1% (95%CI: 23.0, 33.1%) to 77.6% (95%CI: 63.8, 91.4%). Compared with non-disabled elderly, the multiple-adjusted hazard ratio of death due to disability was 1.68 (95% CI: 1.48, 1.90). The hazard ratios varied from 1.44 (95%CI: 1.23, 1.67) to 4.45 (95%CI: 2.69, 7.38) after classifying the disability levels. The hazard ratios of death in the young-old group (65–79 years) were higher than the old-old group (80 years and over) in both level B (HR = 1.58, 95%CI: 1.25, 2.00 vs. HR = 1.22, 95%CI: 1.06, 1.39, P = 0.029) and level G (HR = 24.09, 95%CI: 10.83, 53.60 vs. HR = 2.56, 95%CI: 1.75, 3.74, P < 0.001). For patients with hypertension, diabetes, heart disease, cerebrovascular disease as well as dementia, disability increases their relative risk of mortality by 1.64 (95%CI: 1.40, 1.93), 2.85 (95%CI: 1.46, 5.58), 1.45 (95%CI: 1.02, 2.05), 2.13 (95%CI: 1.54, 2.93) and 3.56 (95%CI: 1.22, 10.38) times, respectively. Conclusions Disability increases the risk of all-cause death in the elderly, especially those with chronic diseases and the young-old group. Further studies are needed to better understand how to effectively prevent disability in the older population.
format	article
author	Yang Yang Zhaohui Du Yafei Liu Jiahui Lao Xiaoru Sun Fang Tang
author_facet	Yang Yang Zhaohui Du Yafei Liu Jiahui Lao Xiaoru Sun Fang Tang
author_sort	Yang Yang
title	Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
title_short	Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
title_full	Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
title_fullStr	Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
title_full_unstemmed	Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
title_sort	disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b67bf538d86241a4bcdcafbc609d58f6
work_keys_str_mv	AT yangyang disabilityandtheriskofsubsequentmortalityinelderlya12yearlongitudinalpopulationbasedstudy AT zhaohuidu disabilityandtheriskofsubsequentmortalityinelderlya12yearlongitudinalpopulationbasedstudy AT yafeiliu disabilityandtheriskofsubsequentmortalityinelderlya12yearlongitudinalpopulationbasedstudy AT jiahuilao disabilityandtheriskofsubsequentmortalityinelderlya12yearlongitudinalpopulationbasedstudy AT xiaorusun disabilityandtheriskofsubsequentmortalityinelderlya12yearlongitudinalpopulationbasedstudy AT fangtang disabilityandtheriskofsubsequentmortalityinelderlya12yearlongitudinalpopulationbasedstudy
_version_	1718408163167830016

Disability and the risk of subsequent mortality in elderly: a 12-year longitudinal population-based study

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