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Mortality and Associated Risk Factors in Community-Dwelling Persons With Early Dementia

Barrett, Blake MSPH; Schultz, Susan K. MD; Luther, Stephen L. PhD; Friedman, Yvonne MA, OTR/L; Cowan, Linda PhD, FNP-BC, CWS; Bulat, Tatjana MD, CMD

Alzheimer Disease & Associated Disorders: August 30, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/WAD.0000000000000343
Original Article: PDF Only
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Objective: Examine mortality and associations with baseline characteristics among Veterans with early dementia.

Methods: Participants included dyads of community-based Veterans with early dementia and their caregivers (N=143) enrolled in a previous longitudinal study. Department of Veterans Health Affairs’ electronic records were used to retrospectively collect Veteran mortality outcomes, over a 6-year period. Measures included baseline: demographics, dementia-related factors, other comorbid conditions, functioning, and medication use. Associations with baseline characteristics and mortality were examined with bivariate analyses and a series of Cox proportional hazard models.

Results: Over 6 years of study follow-up, 53.1% of participants died. The mean time to death was 3.09 years, with a range of 54 days to 5.91 years. Female sex, better cognition, and higher scores on the Tinetti Gait and Balance scale were protective factors in the final multivariable model, adjusting for other characteristics.

Conclusions: While newly diagnosed with early dementia, over half of our sample died in the 6-year follow-up period, with the average death occurring only 3 years after initial diagnosis. The finding of lower mortality associated with better performance on gait/balance testing indicates an important opportunity for focused interventions and early detection of gait and balance changes early during cognitive decline.

VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL

Supported by a Department of Veterans’ Affairs Health Services Research and Development grant (Project NRI 04-183-3), the VA National Center for Patient Safety (NCPS), and the James A. Haley Veterans’ Hospital and Clinics. Human Subjects protection oversight was provided by VA Central Institutional Review Board (IRB), James A. Haley Veterans’ Hospital Research & Development, and the University of South Florida IRB (#106277).

The views expressed in this poster do not necessarily reflect the official policy or position of the Department of Veterans Affairs.

B.B., T.B., S.K.S., S.L.L. (July 2017). Mortality and associated risk factors in community-dwelling persons with early dementia. Poster presented at the 21st IAGG World Congress of Gerontology and Geriatrics, San Francisco, CA. B.B., T.B., S.K.S., S.L.L. (May 2017). Mortality and associated risk factors in community-dwelling persons with early dementia. Poster presented at the 19th annual James A. Haley VA Hospital Research Day, Tampa, FL.

T.B. and S.L.L.: collaborated on study design for initial primary study used as basis for current study. Y.F.: assisted in primary and secondary study data acquisition, in initial and subsequent studies. B.B., T.B., S.K.S., and S.L.L.: collaborated on design of secondary analysis of primary dataset and current analyses. B.B.: conducted study analyses and completed initial manuscript draft. S.K.S.: drafted language on clinical implications of gait findings and reviewed and edited initial draft. S.K.S. and L.C.: both provided assistance in clinical interpretation of study modeling. S.L.L: provided assistance in statistical reporting and interpretation.

The authors declare no conflicts of interest.

Reprints: Blake Barrett, MSPH, VISN 8 Patient Safety Center of Inquiry, James A. Haley VA Hospital, 8900 Grand Oak Circle, Tampa, FL 33637 (e-mail: blake.barrett@va.gov).

Received March 13, 2019

Accepted July 29, 2019

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