Alzheimer's disease and mortality in traditional long-term care facilities

Arch Gerontol Geriatr. May-Jun 2013;56(3):437-41. doi: 10.1016/j.archger.2012.12.001. Epub 2012 Dec 23.

Abstract

Although there is evidence that different types of dementia share similar pathophysiologic mechanisms, research studies support the concept that dementia of the Alzheimer type (AD) is a distinct clinical entity, which may differ in terms of disease progression and outcome. We assessed whether a diagnosis of probable AD in elderly patients admitted to traditional long-term care facilities results in different mortality rates. We analyzed data belonging to a prospective, multi-center (n=4) cohort study involving 378 long-term care facility residents. In our population the prevalence of dementia (any-type) and AD were 46.3% and 11.9%, respectively. During a median follow-up of 5.7 years [25-75th percentile, 2.6-6.9], 262 (69.3%) elderly died. Compared to other admission diagnoses, AD was characterized by lower mortality rates: all-cause hazard risk (HR), 0.64 [95% CI, 0.41-0.99] (P=0.048); HR for cardiovascular (CV) causes, 0.40 [95% CI, 0.20-0.78] (P=0.008). Pre-specified subgroup analyses restricted to patients with dementia (n=175) provided similar results. HRs for AD were: all-cause, 0.60 [95% CI, 0.35-1.00] (P=0.049); CV, 0.43 [95% CI, 0.20-0.91] (P=0.028). However, any-type dementia did not show any difference in risk when compared to other admission diagnosis. In conclusion, probable AD was associated with reduced mortality risk in traditional long-term care facilities. The reasons for these findings deserve further investigation; peculiar pathophysiological features could not be excluded.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alzheimer Disease / mortality*
  • Disease Progression
  • Humans
  • Italy / epidemiology
  • Long-Term Care*
  • Prognosis
  • Prospective Studies
  • Survival Rate / trends