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2014 ; 26
(6
): 768-76
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A comparison of methods for assessing mortality risk
#MMPMID25088793
Levine ME
; Crimmins EM
Am J Hum Biol
2014[Nov]; 26
(6
): 768-76
PMID25088793
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OBJECTIVES: Concepts such as Allostatic Load, Framingham Risk Score, and
Biological Age were developed to combine information from multiple measures into
a single latent variable that can be used to quantify a person's biological
state. Given these varying approaches, the goal of this article is to compare how
well these three measures predict subsequent all-cause and disease-specific
mortality within a large nationally representative U.S. sample. METHODS: Our
study population consisted of 9,942 adults, ages 30 and above from National
Health and Nutrition Examination Survey III. Receiver Operating Characteristic
curves and Cox Proportional Hazard models for the whole sample and for stratified
age groups were used to compare how well Allostatic Load, Framingham Risk Score,
and Biological Age predict ten-year all-cause and disease-specific mortality in
the sample, for whom there were 1,076 deaths over 96,420 person years of
exposure. RESULTS: Overall, Biological Age predicted 10-year mortality more
accurately than other measures for the full age range, as well as for
participants ages 50 to 69 and 70+. Additionally, out of the three measures,
Biological Age had the strongest association with all-cause and cancer mortality,
while the Framingham Risk Score had the strongest association with CVD mortality.
CONCLUSIONS: Methods for quantifying biological risk provide important approaches
to improving our understanding of the causes and consequences of changes in
physiological function and dysregulation. Biological Age offers an alternative
and, in some cases a more accurate summary approach to the traditionally used
methods, such as Allostatic Load and Framingham Risk Score.
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