Clinicians may be able to reliably forecast death in dementia-afflicted older persons with the aid of a prognosis prediction model.
The researchers estimate that 6.5 million Americans age 65 or older have Alzheimer’s disease or another type of dementia. Financial planning, clinical decisions, the use of long-term care, and other types of decisions for this population could all be considerably aided by the improvement in the capacity to forecast which people are more likely to survive longer with dementia.
According to the researchers, whose work was published on September 2022 in JAMA Internal Medicine, the tool, which incorporates six parameters including age, sex, body mass index (BMI), and physical fitness, may help doctors better frame talks about treatment and end-of-life decisions with patients.
“We hope that the mortality risk estimates from this model can be used by clinicians in a clinical context with patients and families to facilitate shared decision-making,” said W. James Deardorff, MD, a geriatrician at the University of California, San Francisco (UCSF), and the San Francisco VA Health Care System, who helped conduct the study. “Given that there were no well-established prediction models that are specific to this community-dwelling population with dementia, we sought to develop one.”
“For interventions that have immediate risks or burdens and delayed benefits, such as cancer screening and tight glycemic control in patients with diabetes, life expectancy can help differentiate between patients most likely to benefit vs most likely to be harmed by interventions,” according to the researchers.
Deardorff and his colleagues at UCSF and the University of Michigan in Ann Arbor tracked 4267 men and women who were thought to likely develop dementia over the course of ten years for the study. They were participants in the Health and Retirement Study, a large-scale study of the health and financial conditions of persons aged 50 and older.
Initial residences for all participants were outside of nursing homes. The study’s participants had an average age of 82, and 69% of them were female. With the help of a different group of participants in the National Health and Aging Trends Study, the researchers validated their model. Their model correctly predicted that participants would pass away within a decade, which is thought to be a long time for this demographic.