title: Predictors of Mortality in Dementia: The PRIME Study.
abstract: Dementia is a terminal illness. While various baseline characteristics of patients, such as age, sex, and dementia severity, are known to predict mortality, little research has examined how changes in patients' symptoms over time predict survival. There are also limited data on patients seen in memory clinics, as opposed to other health care settings, and whether antipsychotic medications are associated with mortality in dementia once patients' demographic and clinical features are controlled for.
  
  
  
  To identify predictors of mortality in patients with dementia.
  
  
  
  Of 970 patients recruited from nine memory clinics around Australia, 779 patients had dementia at baseline. Patients completed measures of dementia severity, cognition, functional ability, neuropsychiatric symptoms, caregiver burden, and medication use at baseline and at regular intervals over a three-year period. Mortality data were obtained from state registries eight years after baseline.
  
  
  
  Overall, 447 (57.4%) of the patients with dementia died within the eight years. Older age, male sex, more severe dementia and functional impairment at baseline, greater decline in dementia severity and functional impairment over six months, taking a larger number of medications, and use of atypical antipsychotic medication predicted earlier mortality.
  
  
  
  The findings confirm that demographic and diagnostic features predict the survival of patients with dementia. Importantly, the findings indicate that changes in dementia severity and functional impairment over time predict mortality independently of baseline levels, and provide further evidence for the higher mortality risk of patients taking antipsychotic medications.
authors.affiliation: Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, Australia.|Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Connors
authors.affiliation: University of Melbourne Academic Unit for Psychiatry of Old Age, Melbourne, Australia.|National Ageing Research Institute, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Ames
authors.affiliation: Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Karyn
authors.initials: K
authors.lastname: Boundy
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Clarnette
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Kurrle
authors.affiliation: Faculty of Health, Deakin University, Geelong, Australia.
authors.forename: Alastair
authors.initials: A
authors.lastname: Mander
authors.affiliation: School of Medicine and Population Health, University of Newcastle, Newcastle, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Ward
authors.affiliation: Medical and Cognitive Research Unit, Austin Health, Heidelberg, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Woodward
authors.affiliation: Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, Australia.|Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000401:mortality / Q000523:psychology; D003704:Dementia / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D014150:Antipsychotic Agents
keywords: Death; dementia; longitudinal study; mortality; predictors