RT Journal Article
SR Electronic
T1 Deaths in dementia: a scoping review of prognostic variables
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP 242
OP 252
DO 10.1136/bmjspcare-2020-002217
VO 11
IS 3
A1 Palvinder Kaur
A1 Woan Shin Tan
A1 Pradeep Paul George Gunapal
A1 Yew Yoong Ding
A1 Reuben Ong
A1 Huei Yaw Wu
A1 Allyn Hum
YR 2021
UL http://spcare.bmj.com/content/11/3/242.abstract
AB Objectives To identify the types of factors included in research examining mortality in patients with dementia, and to stratify the identified factors by care settings.Design We systematically searched PubMed, Embase, PsycINFO and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, and identified grey literature from the Networked Digital Library of Theses and Dissertations, Open Grey and Grey Literature Report. Two authors independently screened for eligibility of studies. Independent reviewers extracted relevant study information. We conducted a narrative synthesis of the data.Results We identified 8254 articles, of which 94 met the inclusion criteria. More than half (n=53) were published between 2009 and 2018 with half from Europe. Studies were conducted across hospices/nursing homes (n=25), hospital (n=23), outpatient clinics (n=21), mixed settings (n=15) and in the community (n=10). Nearly 60% adopted a prospective cohort study design with 87% performing multivariable analysis. Overall, 239 variables were identified and classified into six themes—individual factors, health status, functional ability, cognition and mental health, treatments and health system factors. Although a general set of factors were common across all studies, when stratified by care settings, variations were seen in the specific variables included.Conclusion Identifying prognostic variables relevant to the dementia population in each setting is key to facilitate appropriate care plans and to ensure timely access to palliative care options. Future research should also focus on ensuring the replicability of prognostic models and to generate a better understanding of the direct and interacting influence of the identified factors on mortality.