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Differences in survival and healthcare utilization amongst nursing home residents with advanced dementia and frailty compared to other end-of-life conditions: a retrospective cohort study
Yun Cao, Bao Yu Pang, GEOVANA GUIMARÃES DA SILVA, Ling Ling Soh, Wei Ting Chen, Sze Yee Yang, Lindy Leong, Laurence Lean Chin Tan et al.. BMC Palliative Care, 2025-12-07
Topic: Risk, prevention and care in population studies
There were 361 deaths. Median survival was longer for residents with advanced dementia and frailty (16.5 months, 95%CI:13.5–19.5 months, P < 0.001) compared to incurable cancer (8.1 months, 95%CI:5.1–11.1 months, P < 0.001) and end-stage organ failure (7.7 months, 95%CI:3.0-12.4 months, P < 0.001). Residents with incurable cancer (HR 1.62, 95%CI:1.18–2.22, P = 0.003) and end-stage organ failure (HR 1.63, 95%CI:1.15–2.33, P = 0.006) were more likely to die during follow-up. Residents with advanced dementia and frailty had fewer in-person reviews (2.4, P < 0.001) compared to those with incurable cancer (4.5, P < 0.001) and end-stage organ failure (3.2, P < 0.001). Hospitalisations and emergency department visits were similar across groups. Nursing home residents with advanced dementia and frailty live longer and receive fewer in-person reviews at the last 6 months of life than those with other end-of-life conditions. Providers of palliative care would need to adjust service planning and resource allocation for the longer follow-up period required for this group.
Key findings
- Median survival was longer for residents with advanced dementia and frailty (16.5 months, 95%CI:13.5–19.5 months, P < 0.001) compared to incurable cancer (8.1 months, 95%CI:5.1–11.1 months, P < 0.001) and end-stage organ failure (7.7 months, 95%CI:3.0-12.4 months, P < 0.001).
- Residents with incurable cancer (HR 1.62, 95%CI:1.18–2.22, P = 0.003) and end-stage organ failure (HR 1.63, 95%CI:1.15–2.33, P = 0.006) were more likely to die during follow-up.
- Residents with advanced dementia and frailty had fewer in-person reviews (2.4, P < 0.001) compared to those with incurable cancer (4.5, P < 0.001) and end-stage organ failure (3.2, P < 0.001).
- Hospitalisations and emergency department visits were similar across groups.
- Nursing home residents with advanced dementia and frailty live longer and receive fewer in-person reviews at the last 6 months of life than those with other end-of-life conditions.
Why it matters
This retrospective cohort study found that nursing home residents with advanced dementia and frailty lived longer and received fewer in-person reviews in the last six months of life than residents with incurable cancer or end-stage organ failure. It concerns palliative care service planning, not treating, curing or preventing Alzheimer's disease.
Study details
- Study designcohort study
- Effect sizeHR 1.62; HR 1.63
- Evidence strengthModerate
How this study scored 45/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC Palliative Care) |
| Journal's citation record | 1 / 4 | BMC Palliative Care: journal h-index 88 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over 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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author J.S.W. Lee: h-index 8 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Nanyang Technological University: institution h-index 981 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41354788) |
| Free to read | 2 / 2 | Free to read |
| Total | 45 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s12904-025-01957-2
- PubMed: 41354788
- Original source →
- Free full text: BMC Palliative Care →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Cao, Y., Pang, B. Y., DA SILVA, G. G., Soh, L. L., Chen, W. T., Yang, S. Y., et al. (2025). Differences in survival and healthcare utilization amongst nursing home residents with advanced dementia and frailty compared to other end-of-life conditions: a retrospective cohort study. BMC Palliative Care. https://doi.org/10.1186/s12904-025-01957-2
Vancouver
Cao Y, Pang BY, DA SILVA GG, Soh LL, Chen WT, Yang SY, et al. Differences in survival and healthcare utilization amongst nursing home residents with advanced dementia and frailty compared to other end-of-life conditions: a retrospective cohort study. BMC Palliative Care. 2025. doi:10.1186/s12904-025-01957-2. PMID: 41354788.
BibTeX
@article{cao2025-41354788,
author = {Cao, Yun and Pang, Bao Yu and DA SILVA, GEOVANA GUIMARÃES and Soh, Ling Ling and Chen, Wei Ting and Yang, Sze Yee and Leong, Lindy and Tan, Laurence Lean Chin and others},
title = {{Differences in survival and healthcare utilization amongst nursing home residents with advanced dementia and frailty compared to other end-of-life conditions: a retrospective cohort study}},
journal = {BMC Palliative Care},
year = {2025},
doi = {10.1186/s12904-025-01957-2},
pmid = {41354788},
url = {https://doi.org/10.1186/s12904-025-01957-2}
}
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