Mortality and its predictors among people with dementia receiving psychiatric in-patient care
Background Although dementia is a terminal condition, palliation can be a challenge for clinical services. As dementia progresses, people frequently develop behavioural and psychological symptoms, sometimes so severe they require care in specialist dementia mental health wards. Although these are...
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Cambridge University Press
2025-05-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472425000407/type/journal_article |
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| author | Oriane E. Marguet Shanquan Chen Emad Sidhom Emma Wolverson Gregor Russell George Crowther Simon R. White Jonathan Lewis Rebecca Dunning Shahrin Hasan Benjamin R. Underwood |
| author_facet | Oriane E. Marguet Shanquan Chen Emad Sidhom Emma Wolverson Gregor Russell George Crowther Simon R. White Jonathan Lewis Rebecca Dunning Shahrin Hasan Benjamin R. Underwood |
| author_sort | Oriane E. Marguet |
| collection | DOAJ |
| description |
Background
Although dementia is a terminal condition, palliation can be a challenge for clinical services. As dementia progresses, people frequently develop behavioural and psychological symptoms, sometimes so severe they require care in specialist dementia mental health wards. Although these are often a marker of late disease, there has been little research on the mortality of people admitted to these wards.
Aims
We sought to describe the mortality of this group, both on-ward and after discharge, and to investigate clinical features predicting 1-year mortality.
Method
First, we conducted a retrospective analysis of 576 people with dementia admitted to the Cambridgeshire and Peterborough National Health Service (NHS) Foundation Trust dementia wards over an 8-year period. We attempted to identify predictors of mortality and build predictive machine learning models. To investigate deaths occurring during admission, we conducted a second analysis as a retrospective service evaluation involving mental health wards for people with dementia at four NHS trusts, including 1976 admissions over 7 years.
Results
Survival following admission showed high variability, with a median of 1201 days (3.3 years). We were not able to accurately predict those at high risk of death from clinical data. We found that on-ward mortality remains rare but had increased from 3 deaths per year in 2013 to 13 in 2019.
Conclusions
We suggest that arrangements to ensure effective palliation are available on all such wards. It is not clear where discussions around end-of-life care are best placed in the dementia pathway, but we suggest it should be considered at admission.
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| format | Article |
| id | doaj-art-76bca0b23fb64d679cdec09b7ea851e9 |
| institution | OA Journals |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-76bca0b23fb64d679cdec09b7ea851e92025-08-20T02:28:23ZengCambridge University PressBJPsych Open2056-47242025-05-011110.1192/bjo.2025.40Mortality and its predictors among people with dementia receiving psychiatric in-patient careOriane E. Marguet0Shanquan Chen1Emad Sidhom2Emma Wolverson3Gregor Russell4George Crowther5https://orcid.org/0000-0002-5102-4593Simon R. White6https://orcid.org/0000-0001-8642-7037Jonathan Lewis7Rebecca Dunning8Shahrin Hasan9https://orcid.org/0009-0008-2198-8915Benjamin R. Underwood10https://orcid.org/0000-0003-3427-9487Department of Clinical Neurosciences, University of Cambridge, Cambridge, UKThe London School of Hygiene & Tropical Medicine, London, UKCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UKThe Geller Institute of Ageing and Memory, University of West London, London, UK Humber Teaching NHS Foundation Trust, Hull, UKBradford District Care NHS Foundation Trust, Bradford, UKLeeds and York Partnership NHS Foundation Trust, Leeds, UKDepartment of Psychiatry, University of Cambridge, Cambridge, UK MRC Biostatistics Unit, University of Cambridge, Cambridge, UKCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UKHumber Teaching NHS Foundation Trust, Hull, UKTees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UKCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK Department of Psychiatry, University of Cambridge, Cambridge, UK Background Although dementia is a terminal condition, palliation can be a challenge for clinical services. As dementia progresses, people frequently develop behavioural and psychological symptoms, sometimes so severe they require care in specialist dementia mental health wards. Although these are often a marker of late disease, there has been little research on the mortality of people admitted to these wards. Aims We sought to describe the mortality of this group, both on-ward and after discharge, and to investigate clinical features predicting 1-year mortality. Method First, we conducted a retrospective analysis of 576 people with dementia admitted to the Cambridgeshire and Peterborough National Health Service (NHS) Foundation Trust dementia wards over an 8-year period. We attempted to identify predictors of mortality and build predictive machine learning models. To investigate deaths occurring during admission, we conducted a second analysis as a retrospective service evaluation involving mental health wards for people with dementia at four NHS trusts, including 1976 admissions over 7 years. Results Survival following admission showed high variability, with a median of 1201 days (3.3 years). We were not able to accurately predict those at high risk of death from clinical data. We found that on-ward mortality remains rare but had increased from 3 deaths per year in 2013 to 13 in 2019. Conclusions We suggest that arrangements to ensure effective palliation are available on all such wards. It is not clear where discussions around end-of-life care are best placed in the dementia pathway, but we suggest it should be considered at admission. https://www.cambridge.org/core/product/identifier/S2056472425000407/type/journal_articleDementiabehavioural and psychological symptoms of dementiamortalitypalliative care |
| spellingShingle | Oriane E. Marguet Shanquan Chen Emad Sidhom Emma Wolverson Gregor Russell George Crowther Simon R. White Jonathan Lewis Rebecca Dunning Shahrin Hasan Benjamin R. Underwood Mortality and its predictors among people with dementia receiving psychiatric in-patient care BJPsych Open Dementia behavioural and psychological symptoms of dementia mortality palliative care |
| title | Mortality and its predictors among people with dementia receiving psychiatric in-patient care |
| title_full | Mortality and its predictors among people with dementia receiving psychiatric in-patient care |
| title_fullStr | Mortality and its predictors among people with dementia receiving psychiatric in-patient care |
| title_full_unstemmed | Mortality and its predictors among people with dementia receiving psychiatric in-patient care |
| title_short | Mortality and its predictors among people with dementia receiving psychiatric in-patient care |
| title_sort | mortality and its predictors among people with dementia receiving psychiatric in patient care |
| topic | Dementia behavioural and psychological symptoms of dementia mortality palliative care |
| url | https://www.cambridge.org/core/product/identifier/S2056472425000407/type/journal_article |
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