Long-term survival, place of death, and death certification in clinically diagnosed pre-senile dementia in northern England. Follow-up after 8-12 years.

Abstract

Information on survival and cause of death in pre-senile dementia is scarce and the organisation of services controversial. To study survival, place of death and death certification in pre-senile dementia. Patients aged 45-64 were identified from hospital and community sources in the Northern health region (1985-89) and classified as having pre-senile dementia of Alzheimer type (PDAT) or pre-senile vascular dementia (PVD) by applying an algorithm to case notes. Deaths were ascertained from the National Health Service Central Registry (NHSCR) to 31 December 1998. Survival analysis was performed using the SPSS/PC program, and expected survival calculated from life tables. Median survival time from diagnosis was 6.08 years and did not differ significantly in PDAT and PVD, or by age or gender; 19.3% of deaths occurred at home, 24.5% in nursing or residential homes and 56.3% in hospital; 72.4% of the death certificates mentioned dementia or Alzheimer's disease; 15.4% were still alive. Pre-senile dementia has a variable but usually chronic course, requiring appropriate planning and services.