Cause of death in Alzheimer's disease: a cohort study

Reporting of cause of death in patients with Alzheimer's disease (AD) has changed over the past few decades but concerns persist over the accuracy of death certificate completion in this setting.

To examine the causes of death in AD and examine how this compares with those affecting the normal population.

Death certificates were obtained for 85 AD patients and 52 control subjects from a cohort of 396 participants. Underlying causes of death and other conditions mentioned on the death certificates of the AD patients were analysed and compared with the Northern Ireland population age-and-sex adjusted mortality rates and subsequently to the death certificates of control subjects.

AD and pneumonia were causes of significant excess mortality and the most common underlying causes of death in the AD patient group (23.53 and 17.65%, respectively). When compared with the control subjects, AD and gastrointestinal diseases were found to be more prevalent. AD was recorded on 63.5% of death certificates of AD subjects who died during follow-up.

The cause of death documented for AD patients may be affected by the physician's knowledge of the patient or reflects the approach to management of patients with end-stage dementia.