Mortality Risk Models for Persons with Dementia: A Systematic Review

Area of Science:

• Gerontology
• Neurology
• Public Health

Background:

• Individuals with dementia exhibit higher mortality rates compared to the general population.
• Standardized mortality risk prediction models are needed for effective end-of-life care planning in dementia patients.

Purpose of the Study:

• To systematically review existing prediction models for mortality risk in individuals with dementia.

Main Methods:

• A comprehensive search of Medline and PsycInfo databases was conducted up to November 29, 2020.
• The Prediction model Risk Of Bias ASsessment Tool (PROBAST) was used to evaluate study quality.

Main Results:

• Out of 2,828 identified studies, 18 were included, describing 16 distinct prediction models.
• Two models demonstrated applicability and low risk of bias: one for advanced dementia in nursing homes (6-month mortality) and another for outpatient settings (3-year mortality).
• The outpatient model requires external validation; models for mild to moderate dementia in nursing homes are still needed.

Conclusions:

• Applicable, low-risk prediction models were identified for advanced dementia in nursing homes and for outpatient settings.
• Further model development is necessary for individuals with mild to moderate dementia in nursing homes.
• These models can aid in patient and caregiver education and resource allocation for end-of-life care.