Time from diagnosis to institutionalization and death in people with dementia

Alzheimers Dement. 2020 Apr;16(4):662-671. doi: 10.1002/alz.12063. Epub 2020 Feb 18.


Introduction: Reliable estimates of time from diagnosis until institutionalization and death in people with dementia from routine nationally representative databases are lacking.

Methods: We selected 9230 people with dementia and 24,624 matched controls from family physicians' electronic records linked with national administrative databases to analyze time until institutionalization and death and associated factors.

Results: Median time from recorded diagnosis until institutionalization and until death for people with dementia was 3.9 and 5.0 years, respectively, which was considerably shorter than for controls. Once institutionalized, median time to death was longer for persons with dementia (2.5 years) than for controls (1.2 years). Older age and receiving home care were the strongest predictors of shorter time until institutionalization and death in people with dementia. Gender, cohabitation, migration status, frailty, polypharmacy, and dementia medication were other significant factors.

Discussion: The estimates could help to inform patients, their families, and policymakers about probable trajectories.

Keywords: care trajectories; data linkage; primary care; registry data; risk factors; survival; time to institutionalization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Dementia* / diagnosis
  • Dementia* / mortality
  • Female
  • Humans
  • Institutionalization*
  • Male
  • Middle Aged
  • Nursing Homes*
  • Survival*
  • Time Factors