The vulnerable elders-13 survey predicts 5-year functional decline and mortality outcomes in older ambulatory care patients

Lillian Min, William Yoon, Jeff Mariano, Neil S. Wenger, Marc N. Elliott, Caren Kamberg, Debra Saliba

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Objectives: To test the predictive properties of the Vulnerable Elders-13 Survey (VES-13) a short tool that predicts functional decline and mortality over a 1- to 2-year follow-up interval over a 5-year interval. Design: Longitudinal evaluation with mean follow-up of 4.5 years. SETTING: Two managed-care organizations. PARTICIPANTS: Six hundred forty-nine community-dwelling older adults (≥75) enrolled in the Assessing Care of Vulnerable Elders observational study who screened positive for symptoms of falls or fear of falling, bothersome urinary incontinence, or memory problems. Measurements: VES-13 score (range 1-10, higher score indicates worse prognosis), functional decline (decline in count of 5 activities of daily living or nursing home entry), and deaths. Results: Higher VES-13 scores were associated with greater predicted probability of death and decline in older patients over a mean observation period of 4.5 years. For each additional VES-13 point, the odds of the combined outcome of functional decline or death was 1.37 (95% confidence interval (CI)=1.25-1.50), and the area under the receiver operating curve was 0.75 (95% CI=0.71-0.80). In the Cox proportional hazards model predicting time to death, the hazard ratio was 1.23 (95% CI=1.19-1.27) per additional VES-13 point. Conclusion: This study extends the utility of the VES-13 to clinical decisions that require longer-term prognostic estimates of functional status and survival.

Original languageEnglish (US)
Pages (from-to)2070-2076
Number of pages7
JournalJournal of the American Geriatrics Society
Volume57
Issue number11
DOIs
StatePublished - Nov 1 2009
Externally publishedYes

Fingerprint

Ambulatory Care
Mortality
Confidence Intervals
Accidental Falls
Independent Living
Urinary Incontinence
Managed Care Programs
Activities of Daily Living
Nursing Homes
Proportional Hazards Models
Fear
Observational Studies
Surveys and Questionnaires
Observation
Organizations
Survival

Keywords

  • Functional decline
  • Survival
  • Vulnerable elder

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

The vulnerable elders-13 survey predicts 5-year functional decline and mortality outcomes in older ambulatory care patients. / Min, Lillian; Yoon, William; Mariano, Jeff; Wenger, Neil S.; Elliott, Marc N.; Kamberg, Caren; Saliba, Debra.

In: Journal of the American Geriatrics Society, Vol. 57, No. 11, 01.11.2009, p. 2070-2076.

Research output: Contribution to journalArticle

Min, Lillian ; Yoon, William ; Mariano, Jeff ; Wenger, Neil S. ; Elliott, Marc N. ; Kamberg, Caren ; Saliba, Debra. / The vulnerable elders-13 survey predicts 5-year functional decline and mortality outcomes in older ambulatory care patients. In: Journal of the American Geriatrics Society. 2009 ; Vol. 57, No. 11. pp. 2070-2076.
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