It sounds like a perfect parlor game for baby boomers suddenly confronting their own mortality: What are your chances of dying within four years? Researchers have come up with 12 risk factors to try to answer that for people who are 50 and older.
This is one game where you want a low score. Zero to 5 points says your risk of dying in four years is less than 4 percent. With 14 points, your risk rises to 64 percent.
Just being male gives you 2 points. So does having diabetes, being a smoker, and getting pooped trying to walk several blocks. Points accrue with each four-year increment after age 60. The test doesn't ask what you eat, but it does ask if you can push a living room chair across the floor, reports Forbes.
According to Duluth News Tribune, Covinsky, one of the test designers, said that BMI measurement includes underweight people - those who have lost weight because of illness, a particularly disturbing sign 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 researchers think their mortality predictor might be a useful tool in the "pay for performance" trend that is part of the nation's health care system. Medicare and other insurers are increasingly basing reimbursement rates on how patients fare, said Covinsky.
"One health plan can look better just by cherry-picking health care patients" and accepting only the most robust patients, Covinsky said. This test could give a more accurate assessment of health plans, he said, so that "you can actually see which ones are taking sicker patients and compare that" when measuring performance.
The test appears in Wednesday's Journal of the American Medical Association:
1. Age: 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. Male or Female: Male 2 points.
3. Body-Mass Index: Less than 25 (normal weight or less) 1 point. (Calculate by multiplying height in inches times height in inches; then divide weight in pounds by that total; then multiply the total by 703.)
4. Diabetes: 2 points.
5. 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, 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 percent risk of dying; 6-9 points 15 percent risk; 10-13 points 42 percent risk; 14 or more points 64 percent risk.
Note: Researchers say the 1-point penalty for having a body-mass index under 25 (normal weight or less) is based on findings that being underweight is a health risk for elderly people, informs Washington Post.
O.Ch.
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