Self-Assessment Scores Best Predictors of Mortality

A new study concludes that self-rated questionnaires, without the need for physical examination, are the strongest predictors of 5-year all-cause mortality.

Researchers at Uppsala University (Sweden) conducted a prospective, population-based study to assess sex-specific associations of 655 measurements of demographics, health, and lifestyle with all-cause mortality and six cause-specific mortality categories in 498,103 Biobank (Stockport, United Kingdom) participants from April, 2007, to July, 2010. The researchers excluded variables that were missing in more than 80% of the participants, and all cardio-respiratory fitness test measurements, since summary data were not available. Census information and Life tables were used to calibrate the score to the overall UK population.

The researchers found that self-reported health was the strongest predictor of all-cause mortality in men, and previous cancer diagnosis was the strongest predictor of all-cause mortality in women. When excluding individuals with major diseases or disorders, smoking habits and walking speed were the strongest predictors of all-cause mortality. A prognostic score developed by the researchers that included 13 self-reported predictors for men and 11 for women achieved good discrimination, and significantly outperformed the Charlson comorbidity index.

A dedicated website was developed in collaboration with the Sense About Science (London; United Kingdom) charity, which allows users to interactively explore all of the results, as well calculate a personalized 5-year mortality risk through an online questionnaire. Individuals also uncover their “Ubble age,” the age in which the average mortality risk in the population is most similar to the estimated risk of the individual. The study was published on June 3, 2015, in the Lancet.

“We hope that our score might eventually enable doctors to quickly and easily identify their highest risk patients, although more research will be needed to determine whether it can be used in this way in a clinical setting,” said study co-author Andrea Ganna, PhD. “Of course, the score has a degree of uncertainty and shouldn’t be seen as a deterministic prediction. For most people, a high risk of dying in the next five years can be reduced by increased physical activity, smoking cessation, and a healthy diet.”

“The Ubble website allows anybody in the UK between forty and seventy years old to calculate their ‘Ubble age’ and their risk of dying within the next five years compared to the general population, using a simple set of a dozen or so questions,” said study coauthor Prof. Erik Ingelsson, MD. “This is the first study of its kind which is based on a very large study sample, and is not limited to specific populations, single types of risk, or requiring laboratory testing.”

The UK Biobank is a major national health resource designed to improve the prevention, diagnosis, and treatment of a wide range of serious and life-threatening illnesses, including cancer, heart diseases, stroke, diabetes, arthritis, osteoporosis, eye disorders, depression and some forms of dementia. The Biobank recruited 500,000 people aged between 40–69 years across the UK who provided blood, urine, and saliva samples for future analysis, detailed information about themselves, and agreed to have their health followed over many years.

Related Links:
Uppsala University
UK Biobank
Sense About Science