Assessing risk factors for mortality in elderly white and African American people implications of alternative analyses

Purpose: The aim of this study was to ascertain whether the determinants of death differ as a function of type of analysis in a representative sample of older African American and White people with comparable mortality rates. Design and Methods: Participants included all African American (n = 2,261) and White (n = 1,875) people at the Duke site of the Established Populations for Epidemiological Studies of the Elderly. Baseline information used to predict mortality 12 years later included demographic, health, and functional characteristics. Mortality (55% for African American people and 54% for White people) was determined through the National Death Index. Cox proportional hazards models, logistic regression, and tree-based classification analysis were used (separately for African American and White people) to identify risk factors for mortality. Results: Risk factors for mortality were comparable, but the constellation of characteristics indicating higher risk for death differed between African American and White people. Implications: Proportional hazards and logistic regression identified risk factors in general; tree-based classification models identified the characteristics of groups at risk. The analysis used may influence the type and manner of intervention. Key Words: Proportional hazards models, Logistic regression, Classification tree analysis, Racial differences