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Model Estimates Mortality Risk in Adults with Dementia

Mortality prediction may help guide treatment and advance care planning for community-dwelling older adults with dementia

FRIDAY, Oct. 14, 2022 (HealthDay News) — A mortality prediction model for older adults with dementia may help clinicians have discussions with patients and their families relating to end-of-life care, according to a study published online Sept. 26 in JAMA Internal Medicine.

W. James Deardorff, M.D., from the University of California in San Francisco, and colleagues developed and externally validated a mortality prediction model in community-dwelling older adults with dementia.

The researchers reported that the final model included age, sex, body mass index, smoking status, activities of daily living (ADL) dependency count, instrumental ADL difficulty count, difficulty walking several blocks, participation in vigorous physical activity, and chronic conditions (cancer, heart disease, diabetes, lung disease). After bootstrap internal validation, the optimism-corrected integrated area under the receiver operating characteristic curve (iAUC) was 0.76, with time-specific AUC of 0.73 at one year, 0.75 at five years, and 0.84 at 10 years. In the external cohort, AUC was 0.73 at one year and 0.74 at five years. Across the range of predicted risk from one to 10 years, there was good calibration.

“We developed and externally validated a mortality prediction model in community-dwelling older adults with dementia that showed good discrimination and calibration,” the authors write. “Mortality predictions using this prognostic model may help inform conversations between clinicians, patients, and families related to advance care planning and clinical decisions such as cancer screening.”

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