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Influence of Dementia and Loss of Functional Capacities

Michéle Hébert, MD; Vincenzo Parlato, MD; Gail B. Lese, MD; Ali Dabaj, PhD; Françoise Forette, MD; François Boiler, MD, PhD

Arch Neurol. 1995;52(5):469-476.

Abstract
Background
Several studies have shown a negative correlation between dementia and survival. To our knowledge, the simultaneous effect of other factors has not been systematically studied in institutionalized patients.

Objective
To determine survival in demented inpatients compared with that in a matched population of nondemented patients institutionalized for other chronic debilitating diseases.

Design
The sample consisted of 213 patients with dementia and 157 patients without dementia. We studied the effect on survival of gender, age, loss of functional capacities, and cognitive functions with the method of Kaplan and Meier and with the model of Cox.

Results
Demented patients had significantly shorter survival when other factors were kept constant in the multivariate analysis. There was a strong correlation between survival and the degree of autonomy as measured by ability to walk, continence, and preserved activities of daily living. Survival was significantly shorter for men. No correlation was found with neuropsychological measures of severity of dementia or with age on admission.

Conclusions
Survival of demented patients is shorter than that of patients institutionalized for other invalidating conditions. The lack of correlation between neuropsychological test results and survival indicates that in the population we studied, the severity of dementia did not predict length of survival. The data show that the combination of dementia and loss of functional capacities is the most important factor in predicting survival.

Author Affiliations
From Broca Hospital (Drs Hébert, Forette, and Boiler) and U324, Institut National de la Santé et de la Recherche Médicale (Drs Parlato, Lese, Forette, and Boiler), Paris, France; the Department of Neurology, University of Naples (Italy) (Dr Parlato); and the University of René Descartes (Paris V), Paris (Dr Dabaj).

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