Survival among the older adults with clinical signs of Lewy body dementia in 40 Swedish nursing homes: A 6-year follow-up study

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T1 - Survival among the older adults with clinical signs of Lewy body dementia in 40 Swedish nursing homes

T2 - A 6-year follow-up study

AU - Zahirovic, Iris

AU - Torisson, Gustav

AU - Wattmo, Carina

AU - Londos, Elisabet

PY - 2019

Y1 - 2019

N2 - Objectives: To investigate survival among elderly residents of Swedish nursing homes (NHs), with specific focus on those with two or more signs of Lewy body dementia (LBD). Design: Prospective observational study. Setting: NHs in Malmö, the third largest city in Sweden. Participants: The study population was older adults (aged ≥65 years) living in the 40 NHs in Malmö. Clinical data were collected with a customised questionnaire assessing core clinical LBD signs. Patients were categorised based on 0-1 or 2-4 LBD signs. The head nurse at each NH collected the study data: LBD questionnaires, electronic medication lists and electronic medical records from 2012 to 2013. Main outcome measures: 80-month mortality. Results: Five hundred and fifty-eight (96%) of the residents were deceased at follow-up; among these, mean (95% CI) overall survival time was 29 (28-31) months. Mean survival differed between the LBD groups; those with 0-1 LBD signs lived 8 months longer than those with 2-4 LBD signs. Mortality risk for residents in the LBD 2-4 group was also significantly higher. HR adjusted for age and sex was HR (95% CI) 1.60 (1.30 to 1.97). Mortality risk was also significantly higher in residents with signs of fluctuating cognition 1.36 (1.15 to 1.62), rapid eye movement sleep behaviour disorder 1.49 (1.11 to 1.98), balance problems 1.36 (1.14 to 1.61) or rigidity 1.41 (1.18 to 1.68). Conclusions: This large, longitudinal study shows the important survival effects of identifying and diagnosing older adults NH residents who have two or more LBD signs.

AB - Objectives: To investigate survival among elderly residents of Swedish nursing homes (NHs), with specific focus on those with two or more signs of Lewy body dementia (LBD). Design: Prospective observational study. Setting: NHs in Malmö, the third largest city in Sweden. Participants: The study population was older adults (aged ≥65 years) living in the 40 NHs in Malmö. Clinical data were collected with a customised questionnaire assessing core clinical LBD signs. Patients were categorised based on 0-1 or 2-4 LBD signs. The head nurse at each NH collected the study data: LBD questionnaires, electronic medication lists and electronic medical records from 2012 to 2013. Main outcome measures: 80-month mortality. Results: Five hundred and fifty-eight (96%) of the residents were deceased at follow-up; among these, mean (95% CI) overall survival time was 29 (28-31) months. Mean survival differed between the LBD groups; those with 0-1 LBD signs lived 8 months longer than those with 2-4 LBD signs. Mortality risk for residents in the LBD 2-4 group was also significantly higher. HR adjusted for age and sex was HR (95% CI) 1.60 (1.30 to 1.97). Mortality risk was also significantly higher in residents with signs of fluctuating cognition 1.36 (1.15 to 1.62), rapid eye movement sleep behaviour disorder 1.49 (1.11 to 1.98), balance problems 1.36 (1.14 to 1.61) or rigidity 1.41 (1.18 to 1.68). Conclusions: This large, longitudinal study shows the important survival effects of identifying and diagnosing older adults NH residents who have two or more LBD signs.

KW - elderly

KW - Lewy body dementia

KW - medication

KW - nursing homes

KW - survival

U2 - 10.1136/bmjopen-2018-028010

DO - 10.1136/bmjopen-2018-028010

M3 - Article

C2 - 31152036

AN - SCOPUS:85066621702

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 5

M1 - e028010

ER -