The Vulnerable Elders-13 Survey Predicts 5-Year Functional Decline and Mortality Outcomes in Older Ambulatory Care Patients
Article first published online: 28 SEP 2009
© 2009, Copyright the Authors. Journal compilation © 2009, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 57, Issue 11, pages 2070–2076, November 2009
How to Cite
Min, L., Yoon, W., Mariano, J., Wenger, N. S., Elliott, M. N., Kamberg, C. and Saliba, D. (2009), The Vulnerable Elders-13 Survey Predicts 5-Year Functional Decline and Mortality Outcomes in Older Ambulatory Care Patients. Journal of the American Geriatrics Society, 57: 2070–2076. doi: 10.1111/j.1532-5415.2009.02497.x
- Issue published online: 27 OCT 2009
- Article first published online: 28 SEP 2009
- vulnerable elder;
- functional decline;
OBJECTIVES: To test the predictive properties of the Vulnerable Elders-13 Survey (VES-13) a short tool that predicts functional decline and mortality over a 1- to 2-year follow-up interval over a 5-year interval.
DESIGN: Longitudinal evaluation with mean follow-up of 4.5 years.
SETTING: Two managed-care organizations.
PARTICIPANTS: Six hundred forty-nine community-dwelling older adults (≥75) enrolled in the Assessing Care of Vulnerable Elders observational study who screened positive for symptoms of falls or fear of falling, bothersome urinary incontinence, or memory problems.
MEASUREMENTS: VES-13 score (range 1–10, higher score indicates worse prognosis), functional decline (decline in count of 5 activities of daily living or nursing home entry), and deaths.
RESULTS: Higher VES-13 scores were associated with greater predicted probability of death and decline in older patients over a mean observation period of 4.5 years. For each additional VES-13 point, the odds of the combined outcome of functional decline or death was 1.37 (95% confidence interval (CI)=1.25–1.50), and the area under the receiver operating curve was 0.75 (95% CI=0.71–0.80). In the Cox proportional hazards model predicting time to death, the hazard ratio was 1.23 (95% CI=1.19–1.27) per additional VES-13 point.
CONCLUSION: This study extends the utility of the VES-13 to clinical decisions that require longer-term prognostic estimates of functional status and survival.