Affiliations: [a] Section of Geriatrics, Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, Genova, Italy | [b] Section of General Pathology, Department of Experimental Medicine (DIMES), University of Genova, Genova, Italy | [c] Memory Clinic of Neurology Unit, Galliera Hospital, Genova, Italy | [d] Memory Clinic of ASL4, Chiavari (Genova), Italy
Correspondence:
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Correspondence to: Fiammetta Monacelli, MD, PhD, Department of Internal Medicine and Med Spec (DIMI), Viale Benedetto XV, 6, 16132 Genova, Italy. Tel./Fax: +39 0103537545; E-mail: [email protected].
Abstract: People affected by dementia experienced decreased life expectancy with a 2–4 times higher risk of death at a given age compared to non-demented people. Dementia represents a major cost to health care and society in the Western world and, particularly in Italy, is projected to become a high-resource demanding chronic disease. The present study aimed to estimate the average survival rate of a group of community dwelling elderly affected by dementia in Italy, and to assess the predictive variables associated with survival length. This retrospective study collected the data of patients (n = 290) who died from 2008 to 2012. The data were extracted from a cohort of over 2,000 patients from three outpatient Dementia Clinics of Genoa (Italy). Demographic data and other clinical parameters listed in the patients' clinical records were collected. The mean survival rate after dementia diagnosis was 3.3 ± 0.1 years, lower compared to the age-matched healthy population. The survival rate of these patients showed a significant correlation with age (n = 290; r = −0.16: p < 0.006), with the cognitive status (n = 285; r = 0.16: p < 0.007), with education (n = 204; r = 0.23: p < 0.001), with comorbidity (n = 138; r = −0.41: p < 0.0001), with depressive mood (n = 74; r = 0.44: p < 0.0001), and with the functional status (ADL: n = 242, r = 0.29: p < 0.0001; IADL: n = 243; r = 0.25: p < 0.0001). Multivariate regression revealed age, gender, and functional status as the main determinants informing patient survival. The study provides interesting and reliable data on the pivotal value of early dementia diagnosis in predicting longer survival and addresses comprehensive geriatric assessment, which encompasses most of the predictive variables provided by the study, as a remarkable tool in estimating life expectancy of patients with dementia.
