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Predictors of long-term survival in nonagenarians: the NonaSantfeliu study.

BACKGROUND
few studies have prospectively evaluated long-term predictors of mortality in nonagenarians.


OBJECTIVE
to determine predictors of death in a nonagenarian cohort after 5 years of follow-up.


DESIGN
a prospective community-based study.


SETTING
a community-based study.


SUBJECTS
one hundred and eighty-six nonagenarians both living in the community and institutionalised.


METHODS
functional status was determined by the Lawton-Brody and Barthel Indexes (BI) and cognition by the Spanish version of the mental state examination (MEC). The Charlson Index was used to measure comorbidity. Nutritional status was evaluated by the short version of the Mini-Nutritional Assessment questionnaire.


RESULTS
mortality after 5 years was 75.53%. Patients who did not survive were significantly older, with lower cognitive and functional performance, with diminished visual acuity, higher comorbidity, high risk of malnutrition, higher number of drugs taken and a higher percentage of patients with the diagnosis of dyslipidaemia, heart failure or previous stroke. Cox regression analysis, identified the Charlson Index (hazard ratio 1.23, 95% CI 1.09-1.37) and MEC (hazard ratio 0.98, 95% CI 0.97-0.99) as independent predictors of mortality after 5 years.


CONCLUSIONS
better cognitive status and lesser comorbidity at baseline are the best predictors to identify which nonagenarians survived after a 5-year follow-up period.