Mortality of the Aged with Chronic Brain Syndrome

Abstract

The five-year survival rates for a group of aged persons in a home and hospital for the aged showed that those with chronic brain syndrome (CBS) died at a much higher rate than those without CBS. Bronchopneumonia predominated as the cause of death among those with CBS but not among those without CBS. The mortality for 145 subjects was computed by relating the actual number of deaths to the expected (life tables) number of deaths as a function of age and sex of residents in the same institution. Differences, on the basis of presence or absence of CBS, were statistically significant for females irrespective of whether they were in relatively poor, or relatively good physical condition.

Death Certificate Reporting of Dementia and Mortality in an Alzheimer's Disease Research Center Cohort

“…Two conditions that are conspicuously missing from our lists of frequently reported contributors to mortality are cachexia (reported on two death certificates) and general debility (reported on one certificate), which were reported on only two and one death certificate(s) respectively. The weight loss commonly seen in AD 26 has been shown to be a significant predictor of mortality 27 as has general physical health 28,29 . Like dementia, these important contributors to mortality are probably underreported because of the indirect manner in which they cause the cessation of cardiorespiratory function.…”

Long‐Term Enteral Feeding of Aged Demented Nursing Home Patients

“…Although dementia in the aged shortens remaining life span by one half, 3 the rising numbers of the old‐old with dementia are reflected in their becoming the majority in more and more nursing homes 4 , 5 . Such admissions reflect the difficulty of caring for the demented aged outside of long‐term care facilities, even by devoted caregivers.…”

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

“…5 5 In the original analysis of these data (24), dementia was found to be significantly life‐shortening for females, but not for males. The discrepancy between this result and the result presented here is due to the use of different expectations for mortality.…”

“…The dementias have been estimated to be the underlying cause of death in at least 70,000–100,000 U.S. residents per year; if so, such a rate would make this disorder the fourth or fifth highest cause of death in the United States (1). Although dementia has been ignored in U.S. Vital Statistics Tables as a cause of death (2, 3), a large number of studies (4–25) have investigated its relationship to mortality (Appendix 1 ). However, although these studies have contributed much to our understanding of the relationship between dementia and mortality, they have not simultaneously answered three questions that are of epidemiologic import to the study of dementia:…”

“…1 1 These studies have differed in at least four major ways: 1) the definition of mortality, e.g., years of survival (4–12), versus the probability of surviving X years (8–10, 12–25); 2) the definition of cognitive deficit, e.g., the fixed‐point psychiatric diagnosis of dementia (4–7, 13–25), versus cognitive decline (6, 8–12, 21–23); 3) univariate analyses of the association between dementia/cognitive deficit and mortality (4, 13–19, 24, 25) versus the use of multiple risk factors to predict mortality (5–12, 19–23); and 4) the use of institutional (4–6, 13–18, 20, 22, 24, 25) versus community samples (6–12, 19, 21, 23) for examining the foregoing relationships. …”