palliative geriatrics

Schonberg Index — 10-year Mortality in Older Adults

Predicts mortality of community-dwelling adults aged 65 and over (Schonberg 2009, US National Health Interview Survey) from 11 self-reported factors (0–31 points); validated for 5-, 10- and 14-year mortality (Schonberg 2017). Used to inform cancer-screening and other long-term treatment decisions. Developed without people with dementia or living in care homes.

Score interpretation

0–4 Points — 10-Year Mortality ~12% 0–4

Validation cohort: 10-year mortality 12%, 14-year 23%.

→ Long life expectancy: preventive care and cancer screening with a long lag time to benefit are likely worthwhile, by patient preference.

5–6 Points — 10-Year Mortality ~24% 5–6

Validation cohort: 10-year mortality 24%, 14-year 40%.

→ Most will live beyond 10 years: offer screening and prevention according to patient preference.

7–9 Points — 10-Year Mortality ~39% 7–9

Validation cohort: 10-year mortality 39%, 14-year 60%.

→ Individualise decisions on interventions with a long lag time to benefit; discuss benefits and burdens.

10–12 Points — 10-Year Mortality ~58% 10–12

Validation cohort: 10-year mortality 58%, 14-year 78%.

→ More than half die within 10 years: tests and treatments whose benefit takes 10 years or more to appear (e.g. breast or colorectal cancer screening) are unlikely to help. Discuss goals of care.

≥ 13 Points — 10-Year Mortality ~79% 13–31

Validation cohort: 10-year mortality 79%, 14-year 89%.

→ More than half die within 10 years: tests and treatments whose benefit takes 10 years or more to appear (e.g. breast or colorectal cancer screening) are unlikely to help. Discuss goals of care.

Interpretation bands for the Schonberg. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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