Over 50? Checklist may predict if you'll be alive in 10 years
Although not a crystal ball, researchers say it might help doctors and patients make better choices.
(HealthDay)—A simple checklist could help doctors estimate whether an older patient will be alive 10 years from now, according to a new study.
Researchers hope the findings, reported in the March 6 Journal of the American Medical Association, will help older adults and their doctors come to better decisions on health care.
The checklist could help better tailor advice to older patients, said lead researcher Dr. Marisa Cruz.
"It's meant to be used in a clinical context, to help doctors and older patients discuss screening and other interventions," said Cruz, a clinical fellow at the School of Medicine at the University of California, San Francisco.
Guidelines on cancer screening tests and other interventions vary, but they are based on averages. And some guidelines suggest age cutoffs for screening, because there's a lack of evidence that the tests benefit the average person past a certain age.
Colon cancer screening is one example. The U.S. Preventive Services Task Force, an independent panel that advises the federal government, says that for most people, colon cancer screening should begin at age 50 and continue only until age 75. Other groups, including the American Cancer Society, do not give an upper age limit, but say doctors should consider an older patient's overall health and life expectancy. For an elderly person in poor health, an aggressive treatment or even a screening test could do more harm than good.
On the other hand, a 75-year-old in good health could live many more years, and may benefit from cancer screenings or aggressive treatments, such as tight blood sugar control in people with diabetes.
Cruz said the checklist used in the new study aims to help older adults get the tests or treatments that might benefit them, and avoid potentially harmful ones.
What it does not do, Cruz said, is give any one person a "cut-and-dried prediction" of what will happen in the next 10 years.
The researchers created the checklist based on data from a national study of nearly 20,000 U.S. adults older than 50. They found that 12 factors, considered together, can give an idea of an older adult's risk of dying within 10 years.
Those include age, sex, weight, smoking and whether a person has diabetes, lung disease, heart disease or physical limitations such as difficulty walking a few blocks or moving large objects.
Doctors can get that information using yes-or-no questions, and then assign points for each answer, Cruz said. If you're between 60 and 64 years old, for example, you get one point; if you're 65 to 69 years old, you get two points.
People with a total score of one have, on average, a 5 percent chance of dying in the next 10 years. A score of five translates to a 23 percent chance of dying within a decade, while a score of 10 corresponds to a 70 percent risk.
None of that is set in stone, Cruz said, but the scoring system breaks people into "rough categories" of risk.
Having an idea of an older patient's life expectancy is important because some medical interventions "take a long time to pay off," said Dr. James Pacala, president of the American Geriatrics Society.
"Most cancer screenings, for example, take five to 10 years to pay off," Pacala said. For an older person unlikely to live that long, the risks of screening—such as false-positive results, needless invasive tests and anxiety—are likely to outweigh any benefit.
"If you care for older patients, this is something you always have running in the back of your mind," Pacala said. "What is the rest of this patient's life likely to look like?"
Right now, he said, doctors can get an idea by looking up average life expectancy for a patient based on age and sex, and then considering that person's overall health. The checklist in this study, Pacala said, offers a more "formal" way to do that.
"This provides us with evidence-based numbers," he said.
Pacala stressed, however, that decisions on whether to screen for or treat a disease should not be based solely on a number. He said longevity estimates should be used to facilitate discussions between doctors and patients.
A doctor not involved in the study agreed.
"There is absolutely a need for better tools for understanding life expectancy," said Dr. Ethan Basch, an oncologist and director of the cancer outcomes research program at the University of North Carolina School of Medicine, in Chapel Hill.
But no life-expectancy calculator—or any single guideline—is enough, Basch said. "This is one piece of information to help an older patient make an informed, rational decision," he said.
Basch chaired the American Society of Clinical Oncology committee that recently developed the group's guideline on PSA screening for prostate cancer. The society suggests that doctors discuss PSA screening with men who are expected to live for more than 10 years.
PSA screening is controversial because prostate cancer is often slow-growing and will never threaten a man's life. Even if screening catches a prostate tumor, many men may be treated unnecessarily.
For a man expected to live fewer than 10 years, the ASCO says the potential harms of PSA screening seem to outweigh the benefits. For men with a longer life expectancy, the group says things are not so clear-cut, and having a conversation with your doctor might be worthwhile.
More information: Learn more about screening tests from the U.S. Preventive Services Task Force.
Journal reference: Journal of the American Medical Association
- Expert panel suggests PSA test may benefit some men Jul 16, 2012 | not rated yet | 0
- Cancer screening unlikely to benefit patients with a short life expectancy Jan 08, 2013 | not rated yet | 0
- Researchers find many elderly men are undergoing unnecessary PSA screenings Mar 28, 2011 | not rated yet | 0
- Age, life expectancy influence termination of PSA screening Apr 26, 2012 | not rated yet | 0
- Screening debate typifies prostate cancer uncertainties Aug 10, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
Emergency physicians are key decisionmakers for nearly half of all hospital admissions, highlighting a critical role they can play in reducing health care costs, according to a new report from the RAND Corporation.
Health 20 minutes ago | not rated yet | 0
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).
Health May 18, 2013 | not rated yet | 0 |
Research shows that the earlier the age at which youth take their first alcoholic drink, the greater the risk of developing alcohol problems. Thus, age at first drink (AFD) is generally considered a powerful predictor of ...
Health May 17, 2013 | not rated yet | 0
One quarter of British lawmakers believe there is an "unhealthy" drinking culture in the Houses of Parliament, according to a survey published on Friday.
Health May 17, 2013 | not rated yet | 0
Researchers at the University of Cincinnati (UC) have found that the race and sex of study personnel can influence a patient's decision on whether or not to participate in clinical research.
Health May 17, 2013 | not rated yet | 0
A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...
57 minutes ago | not rated yet | 0 |
Whole-cell pertussis vaccines were more effective at protecting against pertussis than acellular pertussis vaccines during a large recent outbreak, according to a new Kaiser Permanente study published in Pediatrics.
44 minutes ago | not rated yet | 0 |
Optimal treatment of sleep apnea in patients with prediabetes improves blood sugar (glucose) levels and thus can reduce cardiometabolic risk, according to a study to be presented at the ATS 2013 International Conference in ...
30 minutes ago | not rated yet | 0 |
Touted for safety, ease and patient convenience, peripherally inserted central catheters have become many clinicians' go-to for IV delivery of antibiotics, nutrition, chemotherapy, and other medications.
1 hour ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
50 minutes ago | not rated yet | 0
A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...
30 minutes ago | not rated yet | 0