The Impact of Frailty and Comorbidity on Institutionalization and Mortality in Persons With Dementia: A Prospective Cohort Study

Journal of the American Medical Directors Association
Miriam L HaaksmaRené J F Melis

Abstract

The predictive value of frailty and comorbidity, in addition to more readily available information, is not widely studied. We determined the incremental predictive value of frailty and comorbidity for mortality and institutionalization across both short and long prediction periods in persons with dementia. Longitudinal clinical cohort study with a follow-up of institutionalization and mortality occurrence across 7 years after baseline. 331 newly diagnosed dementia patients, originating from 3 Alzheimer centers (Amsterdam, Maastricht, and Nijmegen) in the Netherlands, contributed to the Clinical Course of Cognition and Comorbidity (4C) Study. We measured comorbidity burden using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) and constructed a Frailty Index (FI) based on 35 items. Time-to-death and time-to-institutionalization from dementia diagnosis onward were verified through linkage to the Dutch population registry. After 7 years, 131 patients were institutionalized and 160 patients had died. Compared with a previously developed prediction model for survival in dementia, our Cox regression model showed a significant improvement in model concordance (U) after the addition of baseline CIRS-G or FI when examining mo...Continue Reading

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Citations

Feb 6, 2020·International Journal of Geriatric Psychiatry·Carolien E M BenraadMarcel G M Olde Rikkert
Sep 17, 2019·International Psychogeriatrics·Lindsay M K WallaceOlga Theou
Feb 9, 2021·Journal of the American Medical Directors Association·Alessandra MarengoniDavide Liborio Vetrano
Jan 26, 2021·Journal of Alzheimer's Disease : JAD·Eric E Smith, Zahinoor Ismail

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