Study focuses on tool to predict risk of death for people suffering from dementia

A tool to predict the risk of death and admission to a long-term care facility for patients with dementia has been developed by researchers, in a breakthrough study. It may help conversations among health care providers, patients, and their families.

The study was published in the journal of the Canadian Medical Association.

The recent tragic outbreaks of COVID-19 in long-term care homes highlight the need to have care discussions with residents and their caregivers.

"The majority of residents in long-term care homes have been diagnosed with dementia. 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 Dr Peter Tanuseputro, a family physician and researcher with the Bruyere Research Institute, the Ottawa Hospital Research Institute and ICES, Ottawa, Ontario.

"We 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 five years. This information can be used in conversations about what to expect," said Dr Tanuseputro.

"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," Dr Tanuseputro added.

The study used linked data from ICES on more than 1,08,000 people living in the community in Ontario who was newly diagnosed with dementia from 2010 through 2012.

Researchers found that more than half of individuals (55 per cent) died within 5 years -- comparable to many cancers -- and almost half of those who died (28 per cent) lived in institutions. Only one in four people were still alive and living in the community five 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.

The impact of organ failure on prognosis in people with dementia has not been well documented in other studies. The researchers used data from the paper to develop an online dementia calculator.

Dementia is a progressive, life-limiting illness, and personalised information about survival and potential transition into long-term care facilities like nursing homes can help patients and care providers with prognosis and planning.

This is, however, not always done, perhaps partly because easily accessible tools have not been available. The global prevalence of dementia is increasing and is expected to triple by 2050.

"For patients, families, and caregivers, these conversations can be difficult and too often they don't happen at all," said Dr Tanuseputro.

"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 maximize the quality of life remaining," added Dr Tanuseputro.

( With inputs from ANI )