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A National Study of the Location of Death for Older Persons with Dementia
Susan L. Mitchell, Joan M. Teno, Susan C. Miller, Vincent Mor. Journal of the American Geriatrics Society, 2005-01-26
Topic: Risk, prevention and care in population studies
The majority of dementia-related deaths in the United States occurred in nursing homes (66.9%). In contrast, most older persons with cancer died at home (37.8%) or in the hospital (35.4%). The hospital was the most common site of death for all other conditions (52.2%). The state-specific proportion of dementia-related deaths occurring in hospitals varied from 5.0% to 37.0% across the nation and was in the highest tercile in 18 states. Hospital death rates related to cancer and all other conditions were in the highest tercile in 14 of these 18 states. After multivariate adjustment, states with a greater number of hospital beds per 1,000 persons and a lower percentage of decedents aged 85 and older were more likely to have a higher proportion of hospital deaths in all three decedent groups. Additionally, in the dementia cohort, states with fewer nursing home beds had a greater proportion of hospital deaths. The majority of older Americans whose underlying cause of death is attributable to dementia on their death certificate die in nursing homes. State-level factors, including the availability of hospital and nursing home beds and the age of decedents in the population, explain, in part, the wide state-to-state variability in the proportion of dementia-related deaths occurring in the hospital.
Key findings
- The majority of dementia-related deaths in the United States occurred in nursing homes (66.9%).
- In contrast, most older persons with cancer died at home (37.8%) or in the hospital (35.4%).
- The hospital was the most common site of death for all other conditions (52.2%).
- The state-specific proportion of dementia-related deaths occurring in hospitals varied from 5.0% to 37.0% across the nation and was in the highest tercile in 18 states.
- Hospital death rates related to cancer and all other conditions were in the highest tercile in 14 of these 18 states.
Why it matters
This study describes where older people with dementia die in the United States, finding most died in nursing homes, with state-level variation linked to bed availability and age. It concerns end-of-life care location, not treating, curing, or preventing Alzheimer's disease.
Study details
- Study designcross-sectional
- Participants88,523
- Effect size5.1%; 22.4%; 72.5%
- Evidence strengthModerate
How this study scored 65/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2005 — older than 20 years, still counted |
| Sample size | 4 / 4 | 88,523 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 371 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.1 citations a year over 23 year(s) since 2005 |
| Impact for its field and year | 4 / 6 | Cited 14.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 29 other studies in this library |
| Still being cited | 2 / 4 | Cited 25 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Vincent Mor: h-index 108 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15673356) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Mitchell, S. L., Teno, J. M., Miller, S. C., & Mor, V. (2005). A National Study of the Location of Death for Older Persons with Dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2005.53118.x
Vancouver
Mitchell SL, Teno JM, Miller SC, Mor V. A National Study of the Location of Death for Older Persons with Dementia. Journal of the American Geriatrics Society. 2005. doi:10.1111/j.1532-5415.2005.53118.x. PMID: 15673356.
BibTeX
@article{mitchell2005-15673356,
author = {Mitchell, Susan L. and Teno, Joan M. and Miller, Susan C. and Mor, Vincent},
title = {{A National Study of the Location of Death for Older Persons with Dementia}},
journal = {Journal of the American Geriatrics Society},
year = {2005},
doi = {10.1111/j.1532-5415.2005.53118.x},
pmid = {15673356},
url = {https://doi.org/10.1111/j.1532-5415.2005.53118.x}
}
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