Predictor index of mortality in dementia patients upon entry into long-term care

Background. The purpose of this study was to develop an algorithm that pred icts survival in patients with dementia upon entry into long-term care. The re are, as yet, no predictive equations developed for those in the late sta ges of Alzheimer's disease (AD). Methods. This was a prospective, observational study of 132 patients with d ementia (61% with AD) followed for up to 5.0 years (median of 41.0 months) after admission to a long-term care facility for dementia patients. Informa tion on demographic characteristics, physical health, and cognitive, emotio nal, and behavioral characteristics was collected shortly after admission a nd entered as predictors of time until death in Cox regressions. Findings w ere used to derive an index predicting mortality. Results. There were 60 deaths among the 132 patients (45.4% mortality), wit h an average survival of 22.4 months in those who died. Better physical hea lth and the presence of delusions were associated with longer survival. The se two variables were aggregated into the Copper Ridge Index (CRI), Each on e-point increase on the CRI was associated with a four-fold greater likelih ood of death over 5 years. Conclusions. A predictive equation incorporating measures of general physic al health and delusions accurately predicted time to death in dementia pati ents in long-term care.