What are your chances of dying within four years?
Researchers have come up with 12 risk factors to try to answer that for people over age 50. This is one game where you want a low score. The quiz is designed "to try to help doctors and families get a firmer sense for what the future may hold," to help plan health care accordingly, says lead author Dr. Sei Lee, a geriatrics researcher at the San Francisco Veterans Affairs Medical Center, who helped develop it.
"We know that patients and families want more prognostic information from doctors," Lee said. "It's a very natural human question of 'What's going to happen to me? We also know that doctors are very cautious about giving prognostic information because they don't want to be wrong."
This test is roughly 81 percent accurate and can give older people a reasonable idea of their survival chances, Lee and his colleagues say. Of course, it isn't foolproof. Other experts note it ignores family history and it's much less meaningful for those at the young end of the spectrum.
The researchers even warn not to try this at home, saying a doctor can help you put things into perspective. "Even if somebody looks at their numbers and finds they have a 60 percent risk of death, there could be other mitigating factors," said co-author and VA researcher Dr. Kenneth Covinsky. There are things you can do to improve your chances, he notes, such as quitting smoking or taking up exercise.
The test is based on data involving 11,701 Americans over 50 who took part in a national health survey in 1998. Funded by a grant from the National Institute on Aging, the researchers analyzed participants' outcomes during a four-year follow-up. They based their death-risk survey on the health characteristics that seemed to predict death within four years. Their report appears in the February 15, 2006 issue of the Journal of the American Medical Association.
In one puzzling aspect of the test, people with a body-mass index of less than 25 — which includes normal weight people — get a point while those who are overweight aren't penalized. Covinsky said that BMI measurement includes underweight people — those who have lost weight because of illness, a risk factor for the elderly. As to obesity, Lee noted there are more points for diabetes and for difficulty walking several blocks — both associated with excess weight.
The Test
1. Age: If you're 50-59, 0 points; 60-64 years old, 1 point; 65-69, 2 points; 70-74, 3 points; 75-79, 4 points; 80-84, 5 points; 85 and older, 7 points.
2. If you're a man, 2 points.
3. Weighing too little in relation to height adds 1 point. How to figure: Your body mass index needs to be 25 or higher. This is counter to doctors' orders to keep that number low -- and thus avoid being overweight. But remember: The measure is weighing too little -- a health risk for older people. The figure is computed by dividing weight in pounds by the square of the height in inches, and multiplying by 703.
4. If you're a diabetic, 2 points.
5. Have cancer (excluding minor skin cancers): 2 points.
6. Chronic lung disease that limits activities or requires oxygen use at home: 2 points.
7. Congestive heart failure: 2 points.
8. Cigarette smoking in the past week: 2 points.
9. Difficulty bathing/showering because of a health or memory problem: 2 points.
10. Difficulty managing money, paying bills or keeping track of expenses because of a health or memory problem: 2 points.
11. Difficulty walking several blocks because of a health problem: 2 points.
12. Difficulty pushing or pulling large objects like a living room chair because of a health problem: 1 point.
Score:
0 to 5 points: less than a 4% risk of dying within 4 years
6-9 points: 15% risk
10-13 points: 42% risk
14 or more points: 64% risk