Going from bad to worse: A stochastic model of transitions in deficit accumulation, in relation to mortality

被引:84
作者
Mitnitski, A
Bao, L
Rockwood, K
机构
[1] Dalhousie Univ, Geriatr Med Res Unit, Halifax, NS B3H 2E1, Canada
[2] Dalhousie Univ, Dept Med, Halifax, NS B3H 1V7, Canada
基金
加拿大健康研究院;
关键词
ageing; health transitions; Markov chain; frailty;
D O I
10.1016/j.mad.2006.01.007
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
As people age, they accumulate deficits. The more deficits they accumulate, the greater their vulnerability, which can be expressed as the probability to accumulate even more deficits, or to die. The probability of death is known to be exponentially related to the number of deficits. Using data from elderly (aged 65+ years) participants in the Canadian Study of Health and Aging (n = 9008), we investigated the relationship between the number of deficits and the change in the number of deficits over two successive 5 year intervals. We show that the probabilities of changes in the number of deficits, in relation to baseline, are well fitted (R-2 > 0.98) by a simple distribution, with two parameters. The model suggests a maximum to deficit accumulation, and illustrates no level of deficit accumulation at which there is a net gain in fitness. Age-related deficit accumulation is highly characteristic, and can be modeled as a stochastic process with readily interpretable parameters. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:490 / 493
页数:4
相关论文
共 12 条
[1]   Frailty index as a measure of biological age in a Chinese population [J].
Goggins, WB ;
Woo, J ;
Sham, A ;
Ho, SC .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2005, 60 (08) :1046-1051
[2]   What accounts for the wide variation in life span of genetically identical organisms reared in a constant environment? [J].
Kirkwood, TBL ;
Feder, M ;
Finch, CE ;
Franceschi, C ;
Globerson, A ;
Klingenberg, CP ;
LaMarco, K ;
Omholt, S ;
Westendorp, RGJ .
MECHANISMS OF AGEING AND DEVELOPMENT, 2005, 126 (03) :439-443
[3]   Technical papers in support of the Canadian Study of Health and Aging [J].
McDowell, I ;
Rockwood, K ;
Wolfson, C .
INTERNATIONAL PSYCHOGERIATRICS, 2001, 13 :5-6
[4]   Decrease in the relative heterogeneity of health with age: A cross-national comparison [J].
Mitnitski, A ;
Rockwood, K .
MECHANISMS OF AGEING AND DEVELOPMENT, 2006, 127 (01) :70-72
[5]   Relative fitness and frailty of elderly men and women in developed countries and their relationship with mortality [J].
Mitnitski, A ;
Song, X ;
Skoog, I ;
Broe, GA ;
Cox, JL ;
Grunfeld, E ;
Rockwood, K .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2005, 53 (12) :2184-2189
[6]  
Mitnitski A B, 2001, ScientificWorldJournal, V1, P323
[7]   The estimation of relative fitness and frailty in community-dwelling older adults using self-report data [J].
Mitnitski, AB ;
Song, XW ;
Rockwood, K .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2004, 59 (06) :627-632
[8]  
Mitnitski Arnold B, 2002, BMC Geriatr, V2, P1
[9]   Changes with age in the distribution of a frailty index [J].
Rockwood, K ;
Mogilner, A ;
Mitnitski, A .
MECHANISMS OF AGEING AND DEVELOPMENT, 2004, 125 (07) :517-519
[10]   Assessment of individual risk of death using self-report data: An artificial neural network compared with a frailty index [J].
Song, XW ;
Mitnitski, A ;
MacKnight, C ;
Rockwood, K .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (07) :1180-1184