title: Which factors are associated with mortality in institutionalized older adults with dementia?
abstract: Residential facilities are increasingly used as a resource for dependent older adults and a high percentage of patients with dementia die there. Information about the leading medical causes and exposures to risk factors of mortality in institutionalized older patients with dementia could guide the development of clinical management interventions. The data of 387 institutionalized adults aged over 60, diagnosed with dementia, was analyzed retrospectively. Information about sociodemographic, comorbidities, quality of life and leisure and free time variables was collected in a survey answered by caregivers; after 19 months, information was collected on the result variable (living vs. deceased). A multivariate logistic regression model was created to determine the factors associated with mortality, which were: age (odds ratio (OR)=1.986; 95% confidence interval (CI): 1.229-3.209); diabetes (OR=2.322; 1.350-3.996); hypertension (OR=1.695; 1.044-2.752); diseases of the genitourinary system (OR=2.455;1.419-4.248), worsening of health over last twelve months (OR=1.653; 1.018-2.685) and not performing passive (OR=1.616; 0.968-2.700) or social (OR=2.242; 1.170-4.299) leisure activities. Besides age, the number of comorbid illnesses and the inability to perform leisure activities predicted mortality in institutionalized adults with dementia. These predictors might be useful clinical markers for identifying patients at increased risk for mortality.
authors.affiliation: Preventive Medicine Service, Gregorio Marañón University General Hospital, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Navarro-Gil
authors.affiliation: Quality Office, Ministry of Health and Social Protection of Colombia, Bogotá, Colombia.
authors.forename: Abel E
authors.initials: AE
authors.lastname: González-Vélez
authors.affiliation: National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Ayala
authors.affiliation: EULEN Socio-sanitary Services, Madrid, Spain.
authors.forename: Salomé
authors.initials: S
authors.lastname: Martín-García
authors.affiliation: National Center of Epidemiology, Institute of Health Carlos III and CIBERNED, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Martín
authors.affiliation: National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain. Electronic address: jforjaz@isciii.es.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007326:Institutionalization; D007899:Leisure Activities / Q000523:psychology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011788:Quality of Life / Q000523:psychology*; D012112:Residential Facilities; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Comorbidities; Dementia; Mortality; Older adults; Residential care facilities