The prognosis of demented patients — one-year follow-up study of a population sample

Functional decline and mortality after 1-year follow-up of 93 demented elderly subjects from a random population sample (N =795) were studied in Helsinki, Finland. Seventeen (18%) of the demented patients died as compared to only 5% of the non-demented subjects. The age-adjusted risk ratio for 1-year mortality of demented patients was 3.2 (95% confidence interval 1.8–5.6). Forty-four per cent (26/59) of the surviving patients who were not bedridden and incontinent at the very beginning of the study suffered further impairment in the following functions: institutionalization (6/21), losing the ability to walk (5/57) or beginning of incontinence (17/30). Sixteen (21%) surviving subjects were already bedbound, incontinent and institutionalized at the beginning of the study. Age, sex or the degree of dementia did not correlate to mortality or functional decline. The number of patients who were institutionalized during the follow-up was small. The appearance of incontinence and other recorded risk factors (age, degree of dementia or motility) did not seem to predispose to institutionalization. Subjective factors, such as caretaker's burden, probably have a great influence on the ending of home care.