David W. Molloy, MD
In patients with incident dementia, what is the association between various prognostic factors and risk for mortality?
Prospective cohort study followed for 14 years.
2 rural and 3 urban centers in England and Wales, United Kingdom.
Inception cohort of 438 patients > 65 years of age (median age 84 y) who were diagnosed with dementia based on a geriatric mental state examination algorithm. Persons who had prevalent dementia during entry into the cohort or whose onset of dementia could not be estimated were excluded.
Age at onset of dementia, sex, marital status, accommodation type (community or institution), education level (≤ 9 y, 10 to 11 y, or ≥ 12 y), social class (professional, managerial and technical, skilled nonmanual and manual, partly skilled, or unskilled manual), functional status (least, middle, or most impairment on the Blessed Dementia Scale), score on the Mini-Mental State Examination (MMSE) (≤ 17, 18 to 21, 22 to 25, or 26 to 30), self-reported health (excellent, good, fair, or poor), and area deprivation (Townsend Deprivation Score).
Survival times from onset of dementia to death, and mortality.
356 patients (81%) with dementia died. The median survival times from onset of dementia to death are in the Table. Multivariate analysis showed that functional impairment and older age were associated with higher risk for mortality and men had higher risk for mortality than women (Table); marital status, accommodation type, and score on the MMSE did not predict mortality. Univariate analysis showed that education, social class, and self-reported health did not predict mortality and were not included in multivariate analysis.
Functional impairment, older age, and male sex were associated with higher risk for mortality in incident dementia at 14 years.
Predictors for mortality in incident dementia at 14 years*
*BDS = Blessed Dementia Scale; CI defined in Glossary.
†From onset of dementia.
‡Based on multivariate analysis.
Molloy DW. Age, sex, and functional impairment predicted risk for mortality in incident dementia at 14 years. Ann Intern Med. ;149:JC1–13. doi: 10.7326/0003-4819-149-2-200807150-02013
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Published: Ann Intern Med. 2008;149(2):JC1-13.
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