A new tool that predicts risk of death and admission to a long-term care facility for patients with dementia may help conversations between health care providers, patients and their families, according to researchers.
Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. "Our study shows that the survival of many people with dementia is poor. It may be that many would choose care that focuses on comfort care and quality of life should they become acutely ill," said study researcher Dr. Peter Tanuseputro from the Ottawa Hospital Research Institute in Canada.
Asking simple questions
According to the study, published in the Canadian Medical Association Journal, the researchers have developed a tool that asks simple questions about a person at the time of dementia diagnosis and translates it to the chance of dying and of entering a nursing home over the next 5 years. "This information can be used in conversations about what to expect," Tanuseputro said.
"For newly diagnosed dementia patients and their families, personalized information about their trajectory may be helpful to plan for the future, including advance care planning and planning for additional supports," Tanuseputro added.
The study used linked data from the International Credential Evaluation Service (ICES) on more than 108 000 people living in the community in Ontario who were newly diagnosed with dementia from 2010 through 2012.
Maximising quality of remaining life
Researchers found that more than half of individuals (55 percent) died within 5 years -- comparable to many cancers -- and almost half of those who died (28 percent) lived in institutions. Only one in 4 people were still alive and living in the community 5 years after diagnosis.
Older age, male sex and presence of chronic obstructive pulmonary disease (COPD), congestive heart failure and kidney failure at the time of diagnosis of dementia were the most important factors that predicted death and admission to long-term care.
"If we can help patients and families understand what is likely to happen to their health, and what the next few years may hold, it can help with planning, perhaps provide some peace of mind, and ensure they maximise the quality of life remaining," Tanuseputro said.
