Care dependency and survival among female patients with Alzheimer's disease: a two-year follow-up.

AIM To investigate the relationship between the severity of the patient's care dependency on the one hand, and causes of death, co-morbidity, and survival on the other, and to find out which of these factors might be longitudinal predictors of survival. METHODS A two-year follow-up study started in 1994 in the Netherlands. Subjects were 130 female nursing-home patients with Alzheimer's disease (91 severely dependent, and 39 mildly dependent). Features analyzed in 1994 included the scale of care dependency, demographic data, and clinical information. RESULTS In 1994, both subsamples differed significantly with respect to the duration of Alzheimer's disease, duration of stay, and all nursing-care dependency features, but they did not differ significantly in age, age of disease onset, and co-morbidity. In both groups, the main causes of death were cachexia and/or dehydration. Survival prognosis varied with the level of care dependency. Compared to mildly dependent patients, patients with severe dependency had a 20% higher mortality than expected for the general population of the same age. Marital status, education, cardiovascular disease, and four care dependency features: body posture, day/night pattern, communication, and contact with others, are factors that significantly predict survival. CONCLUSION Survival prognosis of patients with Alzheimer's disease varies with the level of care dependency.