Simple tool with ‘good accuracy’ predicts life expectancy in patients with dementia
Using routinely collected patient characteristics, researchers said they were able to predict the life expectancy of patients with dementia with “good accuracy.”
Specifically, the tool is based on four characteristics obtained at diagnosis: the patient’s age, sex, comorbidity status and cognitive performance. It was designed with primary care physicians’ busy schedules in mind, according to Sara Garcia Ptacek, MD, PhD, of the Radboudumc Alzheimer Center in the Netherlands.
“We specifically designed a simpler version for PCPs because we wanted it to be applicable even in settings with time constraints,” she told Healio Primary Care. “Primary care is responsible for a substantial proportion of dementia diagnoses, so it was important to us to develop a tool useful in this setting.”
A second version of the tool, geared towards specialists, utilized the same factors as the tool for PCPs, but also factored in the specific subtype of dementia that the patient had.
The tools were validated in a cohort of 50,076 patients (mean age, 81.6 years; 59.4 women) from health centers in Sweden, including all memory clinics and about 75% of primary care clinics. Patients were followed starting in 2007 for a maximum of 9.7 years.
Researchers reported that by August 2016, 41.6% of the patients had died. Median survival time from dementia diagnosis was 5.1 years (interquartile range = 2.9-8) for women and 4.3 years (interquartile range = 2.3-7) for men. The tools yielded c indexes of 0.7 (95% CI, 0.69-0.71) to 0.72 (95% CI, 0.71-0.73) and showed good calibration, the researchers said. In addition, patients who were older, male, had an increased comorbidity burden and lower cognitive function at diagnosis, a diagnosis of non-Alzheimer’s dementia, lived alone and used more medications were more likely to die during the study period.
“It is important not to interpret results as absolutes,” Ptacek cautioned. “Survival probabilities are just that — probabilities — and patients with low survival probability may live long while patients initially classified as [having higher odds of survival] may die before 3 years.”
Researchers said the results are nearly identical to those of a similar study in the United Kingdom, but the tool needs to be validated in additional cohorts.
“The methods are simple enough, so we hope our colleagues develop their own tool for their own setting.” – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.