Survival among the older adults with clinical signs of Lewy body dementia in 40 Swedish nursing homes: a 6-year follow-up study

Abstract

ObjectivesTo investigate survival among elderly residents of Swedish nursing homes (NHs), with specific focus on those with two or more signs of Lewy body dementia (LBD).DesignProspective observational study.SettingNHs in Malmö, the third largest city in Sweden.ParticipantsThe study population was older adults (aged ≥65 years) living in the 40 NHs in Malmö. Clinical data were collected with a customised questionnaire assessing core clinical LBD signs. Patients were categorised based on 0–1 or 2–4 LBD signs. The head nurse at each NH collected the study data: LBD questionnaires, electronic medication lists and electronic medical records from 2012 to 2013.Main outcome measures80-month mortality.ResultsFive hundred and fifty-eight (96%) of the residents were deceased at follow-up; among these, mean (95% CI) overall survival time was 29 (28–31) months. Mean survival differed between the LBD groups; those with 0–1 LBD signs lived 8 months longer than those with 2–4 LBD signs. Mortality risk for residents in the LBD 2–4 group was also significantly higher. HR adjusted for age and sex was HR (95% CI) 1.60 (1.30 to 1.97). Mortality risk was also significantly higher in residents with signs of fluctuating cognition 1.36 (1.15 to 1.62), rapid eye movement sleep behaviour disorder 1.49 (1.11 to 1.98), balance problems 1.36 (1.14 to 1.61) or rigidity 1.41 (1.18 to 1.68).ConclusionsThis large, longitudinal study shows the important survival effects of identifying and diagnosing older adults NH residents who have two or more LBD signs.