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Death and dementia.

J Keene1, T Hope, C G Fairburn

  • 1University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK. keene@thematictrails.u-net.com

International Journal of Geriatric Psychiatry
|October 19, 2001
PubMed
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This study reveals that pneumonia is the leading cause of death in dementia patients, often underreported on death certificates. Understanding these outcomes aids carers in planning for the advanced stages of dementia.

Area of Science:

  • Gerontology
  • Neurology
  • Pathology

Background:

  • Dementia, including Alzheimer's disease and vascular dementia, significantly impacts individuals and their caregivers.
  • Understanding the terminal phase of dementia and accurate cause-of-death determination is crucial for patient care and public health.

Purpose of the Study:

  • To investigate the terminal phase of dementia and identify common causes of death.
  • To compare autopsy findings with death certificate diagnoses for accuracy.

Main Methods:

  • A prospective, 11-year longitudinal study involving 91 participants with dementia in Oxfordshire, UK.
  • Data collection included behavioral assessments (Present Behavioural Examination), cognitive evaluations, and comparison of autopsy results with death certificate information.

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Main Results:

  • Pneumonia was the primary cause of death (57%) at autopsy, followed by cardiovascular disease (16%) and pulmonary embolism (14%).
  • Death certificates underreported pulmonary embolism and bronchopneumonia, with dementia mentioned in 73% of cases.
  • The average duration of dementia was 8.5 years, with many patients experiencing severe debilitation, mobility loss, and incontinence in the terminal stages.

Conclusions:

  • Autopsy diagnoses provide a more accurate picture of immediate causes of death in dementia patients compared to death certificates.
  • Findings offer valuable prognostic information for family and professional caregivers to assist in planning for the advanced stages of dementia.