Dementia and Other Competing Risks for Mortality in the Institutionalized Aged*

Vitaliano, Peter P.; Peck, Arthur; Johnson, D. A. W.; Prinz, Patricia N.; Eisdorfer, Carl

doi:10.1111/j.1532-5415.1981.tb03354.x

Cited by 25 publications

(10 citation statements)

References 19 publications

(58 reference statements)

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“…Nursing home patients seem to have a less favorable prognosis 24–31 . On average, they have a 2‐year survival rate, after admission, of about 50% (range 30%−65%).…”

Section: Resultsmentioning

confidence: 99%

Survival of Patients with Dementia

Dijk

Dippel

Habbema

1991

J American Geriatrics Society

108

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The evidence on survival in dementia is summarized. There are no reliable data on survival after onset of dementia or after first contact with medical services. People with dementia in outpatient clinics and nursing homes have 2‐year survival rates of 75% (range 60%‐95%) and 50% (range 30%‐65%), respectively. Differences in survival between patients with senile dementia of the Alzheimer's type (SDAT) and multi infarct dementia (MID) are small. Women in nursing homes have a better prognosis than men (2‐year survival rates, 60% vs 40%). Dementia patients have a considerable excess mortality when compared to the vital statistics. There is no evidence for improvement of survival rates during recent decades. Recommendations for future studies are made

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“…Nursing home patients seem to have a less favorable prognosis 24–31 . On average, they have a 2‐year survival rate, after admission, of about 50% (range 30%−65%).…”

Section: Resultsmentioning

confidence: 99%

Survival of Patients with Dementia

Dijk

Dippel

Habbema

1991

J American Geriatrics Society

108

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“…The high prevalence of mental morbidity in institutionalized elderly has been well established 8 – 11 , 21 . We report similar prevalence rates for dementia (59%), delirium (19%), and depression (21%) in a teaching NH.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive impairment and depression occur at higher rates among institutionalized elderly residents than among community‐dwelling subjects 7 . Because of the negative impact of mental morbidity on functional status, behavioral problems and degree of dependence in daily care, 5 , 6 , 8 – 11 screening for psychiatric disorders should be routine for all newly admitted NH patients so that diagnostic evaluation and treatment can be initiated.…”

mentioning

confidence: 99%

Instruments for Screening for Depression and Dementia in a Long‐Term Care Facility

Kafonek¹,

Ettinger²,

Roca³

et al. 1989

J American Geriatrics Society

187

111

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The high prevalence of mental disorders such as depression and dementia in institutionalized elderly patients warrants screening for psychiatric diagnosis in patients newly admitted to long-term care facilities. The diagnostic accuracy of the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) was evaluated against a standardized psychiatric interview. The MMSE was found to be 81% sensitive and 83% specific in screening for dementia using a previously established cutpoint of less than 24/30 points. Adjusting MMSE scores for physical disabilities precluding completion of specific tasks on the MMSE did not significantly change the diagnostic accuracy of the test. The GDS was 47% sensitive and 75% specific in screening for depression using the suggested cutpoint of greater than 13/30 points. The MMSE was significantly correlated with functional status (r = 0.48, P = .0001), but not with the scores on the GDS or the clinical diagnosis of depression. The GDS did not correlate with functional status. In summary, the MMSE is a good screening test for dementia in institutionalized elderly, but the GDS is not sensitive for depression in this population.

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“…This has been documented among people living in the community [39][40][41], as well as in acute hospital [27] and long-term care settings [39,42], using different instruments for the screening of cognitive impairment. Although estimates of the risk of death among patients with AD have varied greatly, most studies, both institutional [43,44] and community-based studies [45,46], have suggested that it is moderately increased as opposed to unaffected people. The risk is not uniformly distributed but is largely confined to those with more severe impairment [47].…”

Section: Discussionmentioning

confidence: 99%

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

Landi

Gambassi²,

Lapane

et al. 1999

Dement Geriatr Cogn Disord

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We conducted a retrospective cohort study to examine whether patients with Alzheimer’s disease (AD) or vascular dementia (VaD) differed in the number and type of associated comorbid conditions. In addition, we evaluated the impact of the severity of cognitive impairment on hospitalization and mortality of patients in each group. We studied 161,106 patients over age 65, with any degree of cognitive impairment, residing in any of 1,573 Medicare/Medicaid-certified nursing homes of 5 states of the USA between 1992 and 1995. Patients were assessed with the federally mandated Minimum Data Set (MDS). The MDS has been cross-linked to Medicare eligibility files and to the Medicare Provider Analysis and Review database. AD patients were younger, and more likely to be female and Caucasian than VaD patients. For comparable levels of cognitive impairment, AD patients appeared to have fewer comorbid conditions, including those that were not risk factors for VaD. In addition, patients with AD had decreased morbidity and mortality relative to patients with VaD. These findings support the hypothesis that AD patients are a healthier group of demented patients.

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Dementia and Other Competing Risks for Mortality in the Institutionalized Aged*

Cited by 25 publications

References 19 publications

Survival of Patients with Dementia

Survival of Patients with Dementia

Instruments for Screening for Depression and Dementia in a Long‐Term Care Facility

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

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