Factors associated with the prognosis of elderly patients with advanced dementia who receive palliative care from geriatric health services facilities.

Abstract

The aim of the present study is to identify the factors associated with the prognosis of advanced dementia patients who are newly admitted to a geriatric health services facility. This retrospective cohort study used data that were obtained on admission in the care-assessment of long-term care facility patients. The 177 participants with advanced dementia were admitted to our facility between 2006 and 2013. The association between the factors in the care-assessment and the three-month-mortality rates were examined throughout the year. At each of the 3-month time points, the mortarity rates of the patients who had total dependence on oral eating or hypoalbuminemia (<3.5 g/dl by BCG method) were significantly higher in comparison to the patients who had neither of these factors. The mortality rates in the patients with a past history of pneumonia (within 3 months) were significantly associated with both factors. At each time point, the three-month-mortality rates showed a significant decrease in the following patients groups (in order): patients with both total dependence on oral eating and hypoalbuminemia, patients with dependence on oral eating or hypoalbuminemia, patients without these two factors. Our results indicate that the factors in the care-assessment. That were associated with the prognosis of patients with advanced dementia on admission may be total dependence on oral eating and hypoalbuminemia. Evaluating the combination of these two factors can be a simple and useful measure to identify advanced dementia patients with a high risk of death who receive palliative care in a geriatric health services facility.