A simple checklist can help primary-care providers evaluate the health risks that influence the longevity of older adults and have informed discussions with patients regarding the choice to undergo various screening tests and other health-maintenance measures. 


“Recent guidelines recommend considering patients’ life expectancy when deciding whether to pursue preventive interventions with long lag times to benefit 
(≥7 years), such as colorectal cancer screening and intensive glycemic control for diabetes,” wrote Marisa Cruz, MD, and colleagues in a research letter published in JAMA. “However, most mortality indices have focused on short-term risk (≤5 years).”


The 12-item index operates on a point system, with the total determining the patient’s 10-year risk of mortality. For example, adults aged 60 to 64 years receive one point, whereas those over age 85 years receive seven points. Such health risks as current tobacco use, chronic lung disease, heart disease and cancers other than skin cancers are each two points. Cognitive and motor skills also factor into the calculations: The ability to manage one’s finances, walk several blocks, and other such activities are assigned one to two points.


“The clinician can ask the patient yes-or-no questions about [the patient’s] health and functional status and then can go over how the patient could benefit from certain medical interventions,” explained Cruz in a statement issued by the University of California-San Francisco, where Cruz is a clinical fellow. 


References

  1. Cruz M et al. JAMA. 2013;309:874-876.