The measurement of health: A comparison of indices of disease severity

Jiska Cohen-Mansfield*, Gregory Pawlson, Steven Lipson, Stefano Volpato

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


This study compared the utility of different health indicators in frail older people, as a component of a larger study of medical evaluations of 183 adult day care participants in five Maryland centers. Indices examined included: number of disease categories, number of active categories, number of severe categories, number of categories with worsening trajectory, and average severity score. In predicting survival, none of the medical indicators without dementia was a strong predictor of survival. When dementia was included, number of categories with worsening trajectory seemed to be the best indicator of survival, with average severity score being a close second. Among the diagnoses, dementia and its severity were the strongest predictors of survival. Prediction of continuous stay in the community (in contrast to death or entry into a nursing home) was significant for most indices and is easier to predict from medical indices than death. Different indicators provided best utility depending on the criterion applied.

Original languageEnglish
Pages (from-to)1094-1102
Number of pages9
JournalJournal of Clinical Epidemiology
Issue number11
StatePublished - 2001
Externally publishedYes


FundersFunder number
National Institute on AgingK01AG000547, RO1 AG08675


    • Adult day care
    • Aged
    • Severity-of-illness index


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