ADL disability and death in dementia in a French population-based cohort: New insights with an illness-death model

Alzheimers Dement. 2016 Aug;12(8):909-16. doi: 10.1016/j.jalz.2016.03.007. Epub 2016 Apr 19.

Abstract

Introduction: Transition to bathing or dressing disability is a milestone in the evolution of dementia. We examined the transition to disability in these specific activities and considered death to be a competitive event and age and sex to be prognostic factors.

Methods: From a large cohort of 570 incident dementia cases screened in two prospective population-based cohorts, the Paquid study, and the Three-City study, we estimated the probabilities of remaining nondisabled, becoming disabled in bathing or dressing, or dying after the diagnosis using an illness-death model.

Results: On average, approximately half of the period (3 years) of living with dementia was free of disability. In women, a higher survival rate was associated with an average of 1 additional year with disability.

Discussion: The joint prediction of death and disability in dementia by an illness-death model gives original and useful parameters for the prognosis and management of dementia.

Keywords: Activities of daily living; Dementia; Follow-up studies; Prognosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Community Health Planning
  • Dementia / epidemiology*
  • Dementia / mortality*
  • Disability Evaluation
  • Disabled Persons / statistics & numerical data*
  • Female
  • France / epidemiology
  • Humans
  • Incidence
  • Male
  • Neurologic Examination
  • Probability
  • Sex Factors