A behavioral rating scale as a predictor for survival of demented nursing home patients

As part of a study towards determinants of survival in nursing home patients with dementia, the prognostic value of a behavioral rating scale for nursing home patients is assessed in an 8-year follow-up study. The 2-year survival rate for the entire cohort (n = 569) was 56%. Women (n = 459) had a 2-year survival rate of 62%, and men (n = 110) had a 2-year survival rate of 40%. Items indicating physical impairment, dependency and apathy had most prognostic value. Items measuring aggressive or depressive behavior, and cognitive impairment were less predictive. These results were confirmed in a multivariate proportional hazards analysis. A prognostic model with age, gender and five behavioral items (needs help when walking, occupied in useful activity, restless at night, utters physical complaints, and socializes with other patients) substantially differentiated in survival chances in patients with dementia. The model gives a predicted 2-year survival chance of less than 20% or more than 80% in 80 of the 569 patients. When adjusted for the variables in the model, previous residence had no prognostic value anymore. Possibilities for further work in this area of research are discussed.