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Journal Article

Incident disability in older adults: prediction models based on two British prospective cohort studies

Authors

Publication date

2015

Summary

Objective: to develop and validate a prediction model for incident locomotor disability after 7 years in older adults.
Setting: prospective British cohort studies: British Women's Heart and Health Study (BWHHS) for development and the English Longitudinal Study of Ageing (ELSA) for validation.
Subjects: community-dwelling older adults.
Methods: multivariable logistic regression models after selection of predictors with backward elimination. Model performance was assessed using metrics of discrimination and calibration. Models were internally and externally validated.
Results: locomotor disability was reported in BWHHS by 861 of 1,786 (48%) women after 7 years. Age, a history of arthritis and low physical activity levels were the most important predictors of locomotor disability. Models using routine measures as predictors had satisfactory calibration and discrimination (c-index 0.73). Addition of 31 blood markers did not increase the predictive performance. External validation in ELSA showed reduced discrimination (c-index 0.65) and an underestimation of disability risks. A web-based calculator for locomotor disability is available (http://www.sealedenvelope.com/trials/bwhhsmodel/).
Conclusions: we developed and externally validated a prediction model for incident locomotor disability in older adults based on routine measures available to general practitioners, patients and public health workers, and showed an adequate discrimination. Addition of blood markers from major biological pathways did not improve the performance of the model. Further replication in additional data sets may lead to further enhancement of the current model.

Published in

Age and Ageing

Volume and page numbers

44 , 275 -282

DOI

http://dx.doi.org/10.1093/ageing/afu159

ISSN

16

Subjects

Disability, Older People, and Health

Links

http://eprints.soton.ac.uk/id/eprint/370560

Notes

Full author list: Nuesch, Eveline ; Pablo, Perel ; Dale, Caroline E. ; Prieto-Merino, David ; Kumari, Meena ; Bowling, Ann ; Ebrahim, Shah and Casas, Juan P.; PDF - Version of record available under License Creative Commons Attribution - see http://eprints.soton.ac.uk/id/eprint/370560; © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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