200341 Which Domains of Health Status Predict Mortality? A Longitudinal Population-Based Study

Monday, November 9, 2009: 11:05 AM

David Feeny, PhD , Kaiser Permanente Center for Health Research, Portland, OR
Heather M. Orpana, PhD , Health Analysis and Measurement Group, Statistics Canada, Ottawa, ON, Canada
Nathalie Huguet, PhD , School of Community Health, Portland State University, Portland, OR
Bentson McFarland, MD , Department of Psychiatry, Oregon Health and Science University, Portland, OR
Mark S. Kaplan, DrPH , School of Community Health, Portland State University, Portland, OR
A number of studies confirm that overall measures of health-related quality of life (HRQL), such as the Health Utilities Index Mark 3 (HUI3), are predictive of mortality (Kaplan et al 2007). This study examined which specific domains of HUI3 (vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain and discomfort) were associated with mortality risk. Data derived from the Longitudinal Canadian National Population Health Survey, consisting of 12,375 women and men aged 18 and older. HUI3 was measured at baseline in 1994/1995. Cox proportional hazards regression models were applied to estimate mortality risks over 12 years. Of the eight domains examined, ambulation (Hazards Ratio [HR] = 0.16; 95% Confidence Interval [CI] = 0.06 0.39) and hearing (HR = 0.19; 95% CI = 0.06 0.60) were significantly associated with an elevated risk of mortality after controlling for an array of potential confounders. This research indicates that ambulation and hearing at baseline are predictive of subsequent mortality. The finding regarding the predictive ability of ambulation is consistent with previous studies; however, the result concerning hearing is novel. It is possible that hearing loss is a marker of neurological decline. Furthermore, hearing loss may contribute to social isolation and subsequent declines in physical and emotional health. This research emphasizes the need to examine further the underlying mechanisms of the association between ambulation or hearing and mortality risks.

Learning Objectives:
Participants will examine evidence on the determinants of health (mortality) and compare competing hypotheses. Participants will identify the baseline dimensions of health status that are predictive of mortality. Participants will analyze the relative importance of deficits in specific dimensions of health versus the impact of problems in multiple dimensions of health.

Keywords: Mortality, Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The authors were co-investigators on the NIA-funded study (Kaplan PI) that generated the findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.