Underlying Cause of Death in Demented and Non-Demented Elderly Canadians

Chamandy, Nicholas; Wolfson, Christina

doi:10.1159/000086287

Cited by 32 publications

(66 citation statements)

References 29 publications

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“…Intracranial hemorrhage occurred only in VaD and AD possibly related to cerebral amyloid angiopathy, but autopsy information was not available. An oncological cause was reported more frequently as cause of death in AD (13%, 7/55 patients) than expected and in contrast to current literature describing a decreased risk of mortality from neoplasms in AD [31,32].…”

Section: Discussioncontrasting

confidence: 69%

Dementia and Rapid Mortality: Who is at Risk?

Staekenborg

Pijnenburg

Lemstra

et al. 2016

JAD

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Abstract.Background: Dementia is typically known for its insidious onset and slowly progressive course, but a subgroup deteriorates fast and dies within years or even months. Objective: The purpose of this study was to characterize dementia patients with a rapidly progressive course to death and evaluate their cause of death. Methods: We retrospectively included all patients from the Amsterdam Dementia Cohort who died within two years after diagnosis. We evaluated the characteristics of these rapid progressors and compared them to patients known to be alive two years after diagnosis ('non-rapid mortality'). Results: We included 129 dementia patients (13% of our total cohort with known follow-up) with rapid mortality (age 72 ± 10 y [29% <65 y], 70[55%]M, MMSE 20 ± 5). Mean(SD) survival was 12 ± 7 months. Compared to non-rapid mortality patients (n = 892; age 68 ± 9, 503(56%)M, MMSE 22 ± 5), patients with rapid mortality were slightly older at time of diagnosis, had lower MMSE scores, more depressive symptoms and higher prevalence of a cardiovascular history (all p < 0.05). Alzheimer's disease (AD, 43%) was most frequent in patients with rapid mortality, but the occurrence was much lower compared to non-rapid mortality patients (71%), while all other dementia diagnoses, especially Creutzfeldt-Jakob disease (CJD), vascular dementia (VaD), and frontotemporal dementia (FTD), were more frequent (p < 0.001). There were no specific characteristics for AD patients with rapid versus non-rapid mortality, especially APOE genotypes and CSF-profiles were comparable (p > 0.70). Cause of death was highly variable without a clear relation to dementia diagnosis, with exception of dementia itself in CJD, intracerebral hematoma in VaD, and motor neuron disease in FTD. Conclusions: Short survival is relatively common (∼13% in our cohort) and occurs in all different types of dementia, with overrepresentation of non-AD dementias like CJD, VaD, and FTD.

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Section: Discussioncontrasting

confidence: 69%

Dementia and Rapid Mortality: Who is at Risk?

Staekenborg

Pijnenburg

Lemstra

et al. 2016

JAD

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“…These studies even found higher RRs when comparing demented patients (community-dwellings with mean age 85. [8,10]. These studies did not provide age specific causes of death.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies have found CVD to be among the leading underlying cause of death as well [8,11], whereas another study have found CVD to be the fifth leading cause of death [10]. RRs in comparison with the general population ranged from 0.37-0.83.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular disease (CVD) and pneumonia are the main attributable causes of death in patients with dementia, as demonstrated in several registry-and autopsy-based studies [6][7][8][9][10][11]. The majority of these studies investigated the causes of death in the entire group of demented patients without making a distinction between sex, age, and type of dementia [6,[9][10][11][12] or they were of a small sample size [6,7,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Underlying Causes of Death in Patients with Dementia to Support Targeted Advance Care Planning

Vorst

Koek

Bots

et al. 2016

JAD

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Leading UCDs were dementia (17.5% in men and 23.7% in women) and cardiovascular disease (CVD) (18.7% and 19.2%, respectively). When compared to the GP, dementia was a more common UCD (RR in men 4.65, 95%CI 4.43-4.88), while CVD (RR in men 0.67, 95%CI 0.65-0.68) and cancer (RR 0.40, 95%CI 0.39-0.41) were less common. These differences were more pronounced in patients aged between 60-69 as compared to those aged ≥90 years. Patients with AD died less often of cerebrovascular diseases as compared to VaD (RR in men 0.53,. Conclusion: UCDs in patients with dementia differs from that of the GP, as dementia is more often and cancer less often an UCD. Although less frequent compared to the GP, CVD also is one of the leading UCDs in patients with dementia. This information is valuable for targeted advance care planning.

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“…The biomedical perspective also may enable ethical decision-making regarding preventive screening and use of certain medications, assessment and early detection of medication side effects, as well as common acute problems in persons with dementia, such as dehydration, pneumonia, constipation, delirium, and urinary tract infection. Attending to these concerns is paramount, as dementia is associated with an increased risk of death from pneumonia (Attems, Konig, Huber, Lintner, & Jellinger, 2005;Chamandy & Wolfson, 2005;Keene, Hope, Fairburn, & Jacoby, 2001), as well as urinary tract infection and dehydration (Fick, Kolanowski, Waller, & Inouye, 2005).…”

Section: Care Deliverymentioning

confidence: 99%

Reframing Person-Centered Nursing Care for Persons With Dementia

Penrod¹,

Yu²,

Kolanowski³

et al. 2007

Res Theory Nurs Prac

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Alzheimer's dementia manifests in a complex clinical presentation that has been addressed from both biomedical and phenomenological perspectives. Although each of these paradigmatic perspectives has contributed to advancement of the science, neither is adequate for theoretically framing a personcentered approach to nursing care. The need-driven dementia-compromised behavior (NDB) model is discussed as an exemplar of midrange nursing theory that promotes the integration of these paradigmatic views to promote a new level of excellence in person-centered dementia care. Clinical application of the NDB promotes a new level of praxis, or thoughtful action, in the care of persons with dementia.

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Underlying Cause of Death in Demented and Non-Demented Elderly Canadians

Cited by 32 publications

References 29 publications

Dementia and Rapid Mortality: Who is at Risk?

Dementia and Rapid Mortality: Who is at Risk?

Evaluation of Underlying Causes of Death in Patients with Dementia to Support Targeted Advance Care Planning

Reframing Person-Centered Nursing Care for Persons With Dementia

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