TY - JOUR
T1 - Identification of Risk Factors for Mortality and Poor-Quality-of-Life Survival in Frail Older Women Participating in the Women's Health Initiative Observational Study
AU - Zaslavsky, Oleg
AU - Woods, Nancy F.
AU - LaCroix, Andrea Z.
AU - Cauley, Jane A.
AU - Johnson, Karen C.
AU - Cochrane, Barbara B.
AU - Sagi, Shira Zelber
N1 - Publisher Copyright:
© 2016, The American Geriatrics Society.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Objectives To identify potentially modifiable factors associated with overall and poor-quality-of-life (QoL) survival in physically frail older women. Design Prospective study with 7 years of follow-up to examine mortality and, in survivors with a QoL measurement within the next 3 years, to examine poor- versus good-QoL patterns of survival. Setting Women's Health Initiative Observational Study (WHI OS). Participants Frail older women (N = 11,070; average age 72.6, range 65-82). Measurements Frailty was defined using the modified Fried criteria. Study outcomes were overall survival and global QoL. Risk factors were measured at the first follow-up clinic visit for WHI OS participants between 1997 and 2001. Results Of 11,070 frail women, 1,487 (13%) died. After 2,677 survivors with poor or unknown QoL were excluded at study baseline, 3,153 (46%) reported good QoL, and 1,263 (18%) reported poor QoL at the end of study follow-up; QoL measures for 2,490 (38%) were unavailable. Older age, history of cardiovascular disease, diabetes mellitus, poor self-rated health, body mass index less than 25.0 kg/m2, waist circumference greater than 88 cm, systolic blood pressure greater than 140 mmHg, high number and severity of somatic symptoms, smoking, and low education were associated with greater likelihood of poor-QoL survival. Cumulative baseline risk scores demonstrated an approximately linear increase in probability of poor-QoL survival with an increase in risk factors. The probability of poor-QoL survival was 0.19 (95% confidence interval (CI) = 0.15-0.22) in those with zero to two risk factors and 0.40 (95% CI = 0.35-0.44) in those with six or more risk factors. Conclusion Several potentially important risk factors for aging well that can be monitored in clinical and research settings, some of which are modifiable, were identified in a large group of frail old women.
AB - Objectives To identify potentially modifiable factors associated with overall and poor-quality-of-life (QoL) survival in physically frail older women. Design Prospective study with 7 years of follow-up to examine mortality and, in survivors with a QoL measurement within the next 3 years, to examine poor- versus good-QoL patterns of survival. Setting Women's Health Initiative Observational Study (WHI OS). Participants Frail older women (N = 11,070; average age 72.6, range 65-82). Measurements Frailty was defined using the modified Fried criteria. Study outcomes were overall survival and global QoL. Risk factors were measured at the first follow-up clinic visit for WHI OS participants between 1997 and 2001. Results Of 11,070 frail women, 1,487 (13%) died. After 2,677 survivors with poor or unknown QoL were excluded at study baseline, 3,153 (46%) reported good QoL, and 1,263 (18%) reported poor QoL at the end of study follow-up; QoL measures for 2,490 (38%) were unavailable. Older age, history of cardiovascular disease, diabetes mellitus, poor self-rated health, body mass index less than 25.0 kg/m2, waist circumference greater than 88 cm, systolic blood pressure greater than 140 mmHg, high number and severity of somatic symptoms, smoking, and low education were associated with greater likelihood of poor-QoL survival. Cumulative baseline risk scores demonstrated an approximately linear increase in probability of poor-QoL survival with an increase in risk factors. The probability of poor-QoL survival was 0.19 (95% confidence interval (CI) = 0.15-0.22) in those with zero to two risk factors and 0.40 (95% CI = 0.35-0.44) in those with six or more risk factors. Conclusion Several potentially important risk factors for aging well that can be monitored in clinical and research settings, some of which are modifiable, were identified in a large group of frail old women.
KW - QoL
KW - aging well
KW - frailty
KW - mortality
KW - symptoms
UR - http://www.scopus.com/inward/record.url?scp=84963959569&partnerID=8YFLogxK
U2 - 10.1111/jgs.14042
DO - 10.1111/jgs.14042
M3 - Article
C2 - 27100579
AN - SCOPUS:84963959569
SN - 0002-8614
VL - 64
SP - 831
EP - 837
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 4
ER -
