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End-of-life decisions in individuals dying with dementia in Belgium
Kenneth Chambaere, Joachim Cohen, Lenzo Robijn, S Kathleen Bailey, Luc Deliens. Journal of the American Geriatrics Society, 2015-02-02
Topic: Health services, long-term care and technology
Response rate was 54.7%. The intense pain and symptoms of individuals with dementia was alleviated less often than those of individuals with cancer (odds ratio (OR) = 0.50, P < .001), and individuals with dementia were more likely to have life-prolonging treatment withheld or withdrawn (OR = 1.40, P = .048). Five individuals with dementia (1.3%) requested euthanasia but did not receive it; 60 (4.7%) individuals with cancer who requested euthanasia received it, and 48 (3.8%) who requested it did not (OR = 0.04, P = .047). Individuals with dementia rarely had capacity to participate in decision-making, which more often involved their families than in individuals with cancer (OR = 1.99, P = .009). Little prospect of improvement (59.7%), pointless life prolongation (54.5%), poor quality of life (46.2%), and prevention of further suffering (37.6%) were important reasons for end-of-life decisions in individuals with dementia. End-of-life decision-making in individuals dying with dementia differs from that in individuals with cancer, more often involving forgoing of life-prolonging treatment and less often involving intensifying pain and symptom treatment. Considerations typically involve the prospects of the individual with dementia as opposed to the severity of their present situation. Optimal processes of advance care planning may address the burdensome decision falling to physicians and family regarding when to allow the individual to die.
Key findings
- The intense pain and symptoms of individuals with dementia was alleviated less often than those of individuals with cancer (odds ratio (OR) = 0.50, P < .001), and individuals with dementia were more likely to have life-prolonging treatment withheld or withdrawn (OR = 1.40, P = .048).
- Five individuals with dementia (1.3%) requested euthanasia but did not receive it; 60 (4.7%) individuals with cancer who requested euthanasia received it, and 48 (3.8%) who requested it did not (OR = 0.04, P = .047).
- Individuals with dementia rarely had capacity to participate in decision-making, which more often involved their families than in individuals with cancer (OR = 1.99, P = .009).
- Little prospect of improvement (59.7%), pointless life prolongation (54.5%), poor quality of life (46.2%), and prevention of further suffering (37.6%) were important reasons for end-of-life decisions in individuals with dementia.
- End-of-life decision-making in individuals dying with dementia differs from that in individuals with cancer, more often involving forgoing of life-prolonging treatment and less often involving intensifying pain and symptom treatment.
Study details
- Participants8,627
- Effect size54.7%; OR = 1.40; 1.3%
- Evidence strengthLow
How this study scored 54/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 30 of the 56 points we could judge it on, which is 54 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 8,627 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 25641376) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 30 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 30 of the 56 points we could judge it on is 54 out of 100. |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Chambaere, K., Cohen, J., Robijn, L., Bailey, S. K., & Deliens, L. (2015). End-of-life decisions in individuals dying with dementia in Belgium. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.13255
Vancouver
Chambaere K, Cohen J, Robijn L, Bailey SK, Deliens L. End-of-life decisions in individuals dying with dementia in Belgium. Journal of the American Geriatrics Society. 2015. doi:10.1111/jgs.13255. PMID: 25641376.
BibTeX
@article{chambaere2015-25641376,
author = {Chambaere, Kenneth and Cohen, Joachim and Robijn, Lenzo and Bailey, S Kathleen and Deliens, Luc},
title = {{End-of-life decisions in individuals dying with dementia in Belgium}},
journal = {Journal of the American Geriatrics Society},
year = {2015},
doi = {10.1111/jgs.13255},
pmid = {25641376},
url = {https://doi.org/10.1111/jgs.13255}
}
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