Mortality index helps doctors assess risk

By James Fuller

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A mortality index has been created, which predicts a person's chances of dying within 10 years.

An inability to push heavy objects, being too thin or a difficulty in managing money were seen as bad long-term signs for the over 50s.

The system, developed by University of California researchers and published in the Journal of the American Medical Association, is points based. A patient is scored against a list of criteria including age, previous illnesses and general health. The higher the score the worse the outlook.

A slightly overweight woman under 60 with none of the index's stipulated health issues would achieve the best possible score of zero.

This registered as a three per cent chance of dying within 10 years.

The worst possible outcome was for a man, 85 years or older, with all of the highlighted conditions.

That would score 26 points and meant a 95 per cent chance of passing away within the next decade.

However, the index was not designed as a self-assessment tool, said its creators, but as an aid for clinicians.

It was intended to enable doctors to assess the worth of expensive medical treatment or procedures in geriatric patients who were unlikely to live 10 more years.

Dr Joe Bourne, who works for Nga Kakano Foundation Family Health Services based in Te Puke, said he had used similar calculators as a way of conveying risk to patients.

"I find the calculators that are available in New Zealand a useful communication tool with patients; when you can show patients 'what if ... you stopped smoking, took a medication to reduce blood pressure, etc'. Risk is a complicated concept to communicate."

However, he said for use in New Zealand it would first have to be established whether the population studied in the USA was similar enough to the local population to make it relevant.

"With Maori and Pacific Island populations having significantly shorter life expectancy than New Zealanders of European descent it is likely that it would have limitations here."

Dr Bourne acknowledged a potential benefit for resource allocation.

"It is interesting that this is being put out there as a tool that will transparently support patients and doctors to make decisions about rational use of limited health resources.

"With the increasing cost of healthcare, it is vital the public are included in debate on how to best use those resources."

The mortality index was created after researchers analysed the data from 20,000 Americans aged over 50, who took part in a national health survey in 1998.

They tracked the participants for 10 years. Nearly 6000 participants died during that time.

Doting dad investing in his health

One Tauranga man has a rosy outlook after registering a low score on a new mortality index calculator.

Rhys Haman notched up three points meaning there should be few issues on the horizon for the fit 57-year-old.

"I got two by default because I'm a bloke and one because I'm lean. I couldn't understand that one being detrimental really. You would've thought if you were overweight it would work against you more."

Mr Haman puts his low tally down to an exercise routine that alternates running and resistance work.

"I do 45 minutes to an hour of weights at Bay BodyFit and then every second day I'll go for an hour run or a two-hour bike ride. That's either around Waikareao Estuary or Pilot Bay and up the Mount."

Bone and muscle density decreases with age and Mr Haman said resistance work helped slow this process.

Running had been part of his routine for over 20 years. The taekwondo black belt also competed in his first ironman competition at the age of 40.

He said he had good reasons for staying healthy. "I've got a family that I love to bits and I want to hang around as long as I can for them. Anything I can do to put off going through the departure gate too soon I'll do."

Mr Haman - who is married to Angie and has a son Taylor, 19, and a daughter Jesse, 16 - said there were other benefits.

"My employer gets a better employee as well," said the Watties territory sales manager. "I think I've had about four days off sick in the last 15 years. Part of that might be genetic but I put a lot of it down to healthy lifestyle."

He said eating healthily and exercising was about discipline.

"It is easier to be lazy, you can always find excuses not to exercise.

"My taekwondo instructor used to say he couldn't understand why, if a man had a problem with his car, he would take it to a garage but anything wrong with his own body he would just ignore it."

One of the mortality index indicators pinpointed a difficulty in managing money because of health or memory problems. Mr Haman said looking after the mind is equally important as you get older.

"I began learning Te Reo a few years ago to exercise the mind as well. It's well known that learning a second language as you age is a great way of activating different parts of the brain."

The 57-year-old said he considered exercise and nutrition an investment in his health.

- Bay of Plenty Times

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