PMID: 11607941Oct 19, 2001Paper

Death and dementia

International Journal of Geriatric Psychiatry
J KeeneR Jacoby

Abstract

To investigate the last phase of dementia and the causes of death; comparing autopsy and death certificate diagnoses. Prospective, 11-year, longitudinal study of behavioural and psychological changes in dementia, with autopsy follow-up. Participants with dementia, living at home with a carer. All lived in Oxfordshire, UK. Ninety-one people with dementia (Alzheimer's disease and/or vascular dementia) who died during the course of the study. At four-monthly intervals, carers were interviewed about the participants' behaviour using the Present Behavioural Examination. Participants were also assessed cognitively. Causes of death were established from death certificates and, where possible, from post-mortem examination. The main immediate cause of death recorded at autopsy was pneumonia (57%), followed by cardiovascular disease (16%) and pulmonary embolus (14%). This agreed with the immediate cause of death on 53% of death certificates. Pulmonary embolism and bronchopneumonia were under-reported on death certificates. Dementia was mentioned on 73% of death certificates. The dementing illness lasted for a mean of 8.5 years with 58% dying in a debilitated state associated with severe dementia. In the period before death, 35% were unab...Continue Reading

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