Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement

Research output: Contribution to journalJournal articlepeer-review

Standard

Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement. / Katsiferis, Alexandros; Nielsen, Pernille Yde; Jensen, Majken K.; Westendorp, Rudi G.J.

In: BMC Geriatrics, Vol. 22, No. 1, 301, 2022.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Katsiferis, A, Nielsen, PY, Jensen, MK & Westendorp, RGJ 2022, 'Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement', BMC Geriatrics, vol. 22, no. 1, 301. https://doi.org/10.1186/s12877-022-02992-x

APA

Katsiferis, A., Nielsen, P. Y., Jensen, M. K., & Westendorp, R. G. J. (2022). Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement. BMC Geriatrics, 22(1), [301]. https://doi.org/10.1186/s12877-022-02992-x

Vancouver

Katsiferis A, Nielsen PY, Jensen MK, Westendorp RGJ. Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement. BMC Geriatrics. 2022;22(1). 301. https://doi.org/10.1186/s12877-022-02992-x

Author

Katsiferis, Alexandros ; Nielsen, Pernille Yde ; Jensen, Majken K. ; Westendorp, Rudi G.J. / Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement. In: BMC Geriatrics. 2022 ; Vol. 22, No. 1.

Bibtex

@article{bde61afeb6c54834a5e3de6963ace266,
title = "Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement",
abstract = "Background: The process of aging renders older people susceptible for adverse outcomes upon stress. Various indicators derived from complex systems theory have been proposed for quantifying resilience in living organisms, including humans. We investigated the ability of system-based indicators in capturing the dynamics of resilience in humans who suffer the adversity of spousal bereavement and tested their predictive power in mortality as a finite health transition. Methods: Using longitudinal register data on weekly healthcare consumption of all Danish citizens over the age of 65 from January 1st, 2011, throughout December 31st, 2016, we performed statistical comparisons of the indicators {\textquoteleft}average{\textquoteright}, {\textquoteleft}slope{\textquoteright}, {\textquoteleft}mean squared error{\textquoteright}, and {\textquoteleft}lag-1 autocorrelation{\textquoteright} one year before and after spousal bereavement, stratified for age and sex. The relation between levels of these indicators before bereavement and mortality hazards thereafter was determined by time to event analysis. We assessed the added value for mortality prediction via the time dependent area (AUC) under the receiver operating characteristic curve. Results: The study included 934,003 citizens of whom 51,890 experienced spousal bereavement and 2862 died in the first year thereafter. Healthcare consumption is increased, more volatile and accelerating with aging and in men compared to women (all p-values < 0.001). All dynamic indicators before bereavement were positively related with mortality hazards thereafter (all p-values < 0.001). The average discriminative performance for the 1-year mortality risk of the model with only age as a predictor (AUC: 68.9% and 70.2%) was significantly increased with the addition of dynamical indicators (78.5% and 82.4%) for males and females, respectively. Conclusions: Dynamic indicators in time series of health care expenditures are strong predictors of mortality risk and could be part of predictive models for prognosis after life stressors, such as bereavement.",
keywords = "Aging, Bereavement, Complex systems, Health, Resilience",
author = "Alexandros Katsiferis and Nielsen, {Pernille Yde} and Jensen, {Majken K.} and Westendorp, {Rudi G.J.}",
note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
doi = "10.1186/s12877-022-02992-x",
language = "English",
volume = "22",
journal = "B M C Geriatrics",
issn = "1471-2318",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement

AU - Katsiferis, Alexandros

AU - Nielsen, Pernille Yde

AU - Jensen, Majken K.

AU - Westendorp, Rudi G.J.

N1 - Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - Background: The process of aging renders older people susceptible for adverse outcomes upon stress. Various indicators derived from complex systems theory have been proposed for quantifying resilience in living organisms, including humans. We investigated the ability of system-based indicators in capturing the dynamics of resilience in humans who suffer the adversity of spousal bereavement and tested their predictive power in mortality as a finite health transition. Methods: Using longitudinal register data on weekly healthcare consumption of all Danish citizens over the age of 65 from January 1st, 2011, throughout December 31st, 2016, we performed statistical comparisons of the indicators ‘average’, ‘slope’, ‘mean squared error’, and ‘lag-1 autocorrelation’ one year before and after spousal bereavement, stratified for age and sex. The relation between levels of these indicators before bereavement and mortality hazards thereafter was determined by time to event analysis. We assessed the added value for mortality prediction via the time dependent area (AUC) under the receiver operating characteristic curve. Results: The study included 934,003 citizens of whom 51,890 experienced spousal bereavement and 2862 died in the first year thereafter. Healthcare consumption is increased, more volatile and accelerating with aging and in men compared to women (all p-values < 0.001). All dynamic indicators before bereavement were positively related with mortality hazards thereafter (all p-values < 0.001). The average discriminative performance for the 1-year mortality risk of the model with only age as a predictor (AUC: 68.9% and 70.2%) was significantly increased with the addition of dynamical indicators (78.5% and 82.4%) for males and females, respectively. Conclusions: Dynamic indicators in time series of health care expenditures are strong predictors of mortality risk and could be part of predictive models for prognosis after life stressors, such as bereavement.

AB - Background: The process of aging renders older people susceptible for adverse outcomes upon stress. Various indicators derived from complex systems theory have been proposed for quantifying resilience in living organisms, including humans. We investigated the ability of system-based indicators in capturing the dynamics of resilience in humans who suffer the adversity of spousal bereavement and tested their predictive power in mortality as a finite health transition. Methods: Using longitudinal register data on weekly healthcare consumption of all Danish citizens over the age of 65 from January 1st, 2011, throughout December 31st, 2016, we performed statistical comparisons of the indicators ‘average’, ‘slope’, ‘mean squared error’, and ‘lag-1 autocorrelation’ one year before and after spousal bereavement, stratified for age and sex. The relation between levels of these indicators before bereavement and mortality hazards thereafter was determined by time to event analysis. We assessed the added value for mortality prediction via the time dependent area (AUC) under the receiver operating characteristic curve. Results: The study included 934,003 citizens of whom 51,890 experienced spousal bereavement and 2862 died in the first year thereafter. Healthcare consumption is increased, more volatile and accelerating with aging and in men compared to women (all p-values < 0.001). All dynamic indicators before bereavement were positively related with mortality hazards thereafter (all p-values < 0.001). The average discriminative performance for the 1-year mortality risk of the model with only age as a predictor (AUC: 68.9% and 70.2%) was significantly increased with the addition of dynamical indicators (78.5% and 82.4%) for males and females, respectively. Conclusions: Dynamic indicators in time series of health care expenditures are strong predictors of mortality risk and could be part of predictive models for prognosis after life stressors, such as bereavement.

KW - Aging

KW - Bereavement

KW - Complex systems

KW - Health

KW - Resilience

U2 - 10.1186/s12877-022-02992-x

DO - 10.1186/s12877-022-02992-x

M3 - Journal article

C2 - 35395751

AN - SCOPUS:85127922942

VL - 22

JO - B M C Geriatrics

JF - B M C Geriatrics

SN - 1471-2318

IS - 1

M1 - 301

ER -

ID: 303957177