Survival in institutionalized patients. Influence of dementia and loss of functional capacities
M. H ebrt, V. Parlato, G. B. Lese, A. Dabaj, F. Forette and F. Boller
Broca Hospital, Paris, France.
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.