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Survival among the older adults with clinical signs of Lewy body dementia in 40 Swedish nursing homes : A 6-year follow-up study

Zahirovic, Iris LU ; Torisson, Gustav LU orcid ; Wattmo, Carina LU and Londos, Elisabet LU (2019) In BMJ Open 9(5).
Abstract

Objectives: To investigate survival among elderly residents of Swedish nursing homes (NHs), with specific focus on those with two or more signs of Lewy body dementia (LBD). Design: Prospective observational study. Setting: NHs in Malmö, the third largest city in Sweden. Participants: The study population was older adults (aged ≥65 years) living in the 40 NHs in Malmö. Clinical data were collected with a customised questionnaire assessing core clinical LBD signs. Patients were categorised based on 0-1 or 2-4 LBD signs. The head nurse at each NH collected the study data: LBD questionnaires, electronic medication lists and electronic medical records from 2012 to 2013. Main outcome measures: 80-month mortality. Results: Five hundred and... (More)

Objectives: To investigate survival among elderly residents of Swedish nursing homes (NHs), with specific focus on those with two or more signs of Lewy body dementia (LBD). Design: Prospective observational study. Setting: NHs in Malmö, the third largest city in Sweden. Participants: The study population was older adults (aged ≥65 years) living in the 40 NHs in Malmö. Clinical data were collected with a customised questionnaire assessing core clinical LBD signs. Patients were categorised based on 0-1 or 2-4 LBD signs. The head nurse at each NH collected the study data: LBD questionnaires, electronic medication lists and electronic medical records from 2012 to 2013. Main outcome measures: 80-month mortality. Results: Five hundred and fifty-eight (96%) of the residents were deceased at follow-up; among these, mean (95% CI) overall survival time was 29 (28-31) months. Mean survival differed between the LBD groups; those with 0-1 LBD signs lived 8 months longer than those with 2-4 LBD signs. Mortality risk for residents in the LBD 2-4 group was also significantly higher. HR adjusted for age and sex was HR (95% CI) 1.60 (1.30 to 1.97). Mortality risk was also significantly higher in residents with signs of fluctuating cognition 1.36 (1.15 to 1.62), rapid eye movement sleep behaviour disorder 1.49 (1.11 to 1.98), balance problems 1.36 (1.14 to 1.61) or rigidity 1.41 (1.18 to 1.68). Conclusions: This large, longitudinal study shows the important survival effects of identifying and diagnosing older adults NH residents who have two or more LBD signs.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
elderly, Lewy body dementia, medication, nursing homes, survival
in
BMJ Open
volume
9
issue
5
article number
e028010
publisher
BMJ Publishing Group
external identifiers
  • scopus:85066621702
  • pmid:31152036
ISSN
2044-6055
DOI
10.1136/bmjopen-2018-028010
language
English
LU publication?
yes
id
6b32f3ae-b708-4a6f-9ba6-3d5a8b225aec
date added to LUP
2019-07-01 14:48:01
date last changed
2024-01-16 06:07:05
@article{6b32f3ae-b708-4a6f-9ba6-3d5a8b225aec,
  abstract     = {{<p>Objectives: To investigate survival among elderly residents of Swedish nursing homes (NHs), with specific focus on those with two or more signs of Lewy body dementia (LBD). Design: Prospective observational study. Setting: NHs in Malmö, the third largest city in Sweden. Participants: The study population was older adults (aged ≥65 years) living in the 40 NHs in Malmö. Clinical data were collected with a customised questionnaire assessing core clinical LBD signs. Patients were categorised based on 0-1 or 2-4 LBD signs. The head nurse at each NH collected the study data: LBD questionnaires, electronic medication lists and electronic medical records from 2012 to 2013. Main outcome measures: 80-month mortality. Results: Five hundred and fifty-eight (96%) of the residents were deceased at follow-up; among these, mean (95% CI) overall survival time was 29 (28-31) months. Mean survival differed between the LBD groups; those with 0-1 LBD signs lived 8 months longer than those with 2-4 LBD signs. Mortality risk for residents in the LBD 2-4 group was also significantly higher. HR adjusted for age and sex was HR (95% CI) 1.60 (1.30 to 1.97). Mortality risk was also significantly higher in residents with signs of fluctuating cognition 1.36 (1.15 to 1.62), rapid eye movement sleep behaviour disorder 1.49 (1.11 to 1.98), balance problems 1.36 (1.14 to 1.61) or rigidity 1.41 (1.18 to 1.68). Conclusions: This large, longitudinal study shows the important survival effects of identifying and diagnosing older adults NH residents who have two or more LBD signs.</p>}},
  author       = {{Zahirovic, Iris and Torisson, Gustav and Wattmo, Carina and Londos, Elisabet}},
  issn         = {{2044-6055}},
  keywords     = {{elderly; Lewy body dementia; medication; nursing homes; survival}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Survival among the older adults with clinical signs of Lewy body dementia in 40 Swedish nursing homes : A 6-year follow-up study}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2018-028010}},
  doi          = {{10.1136/bmjopen-2018-028010}},
  volume       = {{9}},
  year         = {{2019}},
}