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KMID : 0869220090130010024
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Journal of Korean Geriatric Psychiatry
2009 Volume.13 No. 1 p.24 ~ p.31
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Rate and Predictors of Mortality in Elderly Nursing Home Residents with Dementia：5-Year Follow-Up Study
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Lee Sang-Keol
Kim Dae-Hee
Suh Guk-Hee
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Abstract
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Objectives: To investigate mortality rates and predictors of mortality in dementia patients (prevalence cohort resident at institution.
Methods: We followed up a dementia cohort for 5 years. A total of 273 subjects with dementia were longitudinally assessed at baseline, 6 months and 12 months and then checked whether alive or dead every 1 year for 5 years. Their mortality was compared with sociodemographic and clinical variables using Cochran-Mantel-Haenszel test and independent sample t-test. Survival time quartiles were used to describe the time until when 25%, 50%, and 75% of patients died. Kaplan Meier log-rank tests were used for testing the equality of survival among groups when identifying some disruptive agitated behaviors as mortality predictors. Relative risk (RR) with 95% confidence intervals were calculated by the Cox regression analysis.
Results: In this study, overall 5-year mortality rate was 63.0% (12.6% per year). Median survival after baseline evaluation was 2.85 years, whereas median survival after institutionalization was 6.42 years. Log-rank tests revealed that some disruptive behaviors (i.e., Cagras syndrome, screaming, trying to get to a different place, intentional falling) were significantly higher in the deceased group. Mortality in subjects with dementia depended on old age {over 85, relative risk (RR)：1.04；95% confidence interval (CI)：1.02-1.06}, male gender (RR：2.04；CI：1.28-3.25), lower MMSE-K score (RR：1.03；CI：1.00-1.06).
Conclusion: We expect that this study may provide basic health information for health policy making in institutional care approaches in Korea.
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KEYWORD
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Mortality, Dementia, Predictors
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