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Tools for Decision Making Sections
Author Bio
Introduction
Part I
Part II
Age and Co-morbidity
Screening in the Elderly
Case Study 3: Patient Histories

Currently selected section: Estimating Life Expectancy

Approach to Screen Decisions
Calculating the Impact of Co-morbid Illness
Adjusting Life Expectancy
References


Chapter 14: Tools for Decision Making: Simplified Method for Estimating Life Expectancy
        

A very simple way to assess the impact of chronic disease on life expectancy is to ask the patient one question, "How is your health?" and instruct the patient to give a one word answer: "excellent," "good," "fair," or "poor."

Researchers have asked a large number of people this question and then kept track of them long enough for most of them to die. The researchers then calculated the average length of life as a function of the patients' answer to the question about their health, their gender, and their age.

To use this simplified method, follow these steps:

  • Determine the patient's chronological age
  • Ask "How is your health - excellent, good, fair, or poor?"
  • Use a table to determine physiological age (see below, Table 3.4.1 [men], Table 3.4.2 [women]. Physiological age based on chronological age and self-reported health status)
  • Use another table to determine life expectancy based on physiological age (see below, Figure 3.4.1 Life expectancy based on physiological age)
  • Below are tables for determining a person's physiological age, based on their chronological age and their response to the question, "How is your health?"

    Click here for instructions on how to use this table.

    Table 3.4.1: Physiological age based on chronological age and self-reported health status (men)
    EXCELLENT GOOD FAIR POOR
    65 58646873
    7062697378
    7567747883
    8072798385+
    Reference: Welch HG, Albertsen PC, Nease RF, et al. Estimating treatment benefits for the elderly: the effect of competing risks. Ann intern Med. 1996; 124:577-84.

    Click here for instructions on how to use this table.

    Table 3.4.2: Physiological age based on chronological age and self-reported health status (women)
    EXCELLENT GOOD FAIR POOR
    65 60646672
    7065697177
    7570747682
    8075798185+
    Reference: Welch HG, Albertsen PC, Nease RF, et al. Estimating treatment benefits for the elderly: the effect of competing risks. Ann intern Med. 1996; 124:577-84.


    Once you have determined the patient's physiological age (based on their chronological age and self-reported health status), you can look up their estimated life expectancy by using a table like the one below.

    Click here for instructions on how to use this table.

    Figure 3.4.1: Determining Estimated Life Expectancy
    Vertical axis = life expectancy (0-20); horizontal axis = age (65-85). Women and men are represented with downward sloping lines, women demonstrate a higher life expectancy overall. Described in text.
    Reference: Welch HG, Albertsen PC, Nease RF, et al. Estimating treatment benefits for the elderly: the effect of competing risks. Ann Intern Med. 1996; 124:577-84.


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