Home › Research › End-of-life care
Palliative and aggressive end-of-life care for patients with dementia
Evers MM, Purohit D, Perl D, Khan K, Marin DB.. Psychiatric services (Washington, D.C.), 2002-05-01
Topic: Risk, prevention and care in population studies
Objectives The goals of this study were to establish the frequency of palliative and aggressive treatment measures among patients with and without dementia during the last six months of life, to identify relationships between the severity of dementia and aggressive and palliative care, and to determine whether treatment patterns have changed over time. Methods Antemortem data for 279 patients with dementia and 24 control patients who were brought for autopsy in chronic care facilities between 1985 and 2000 were reviewed. The severity of dementia was defined by scores on the Clinical Dementia Rating scale. Data on use of systemic antibiotics (designated as an aggressive treatment measure) and on use of narcotic and nonnarcotic pain medications and nasal oxygen (defined as palliative measures) were collected from medical charts. Results Fifty-three percent of the patients with dementia and 46 percent of those without dementia had received systemic antibiotics. Fourteen percent of the patients with dementia and 38 percent of those without dementia had received narcotic pain medications. The prevalence of aggressive and palliative measures did not vary significantly with the severity of dementia. Eleven percent of the patients with dementia who died between 1991 and 1995 and 18 percent of those who died between 1996 and 2000 had received narcotic pain medications in the last six months of their lives. Conclusions Use of systemic antibiotics is prevalent in the treatment of patients with end-stage dementia, despite the limited utility and discomfort associated with the use of these agents. That patients with severe dementia and those with milder cognitive impairment received similar treatment may be contrary to good clinical practice, given the poor prognosis of patients with severe dementia.
Key findings
- Results Fifty-three percent of the patients with dementia and 46 percent of those without dementia had received systemic antibiotics.
- The prevalence of aggressive and palliative measures did not vary significantly with the severity of dementia.
- Conclusions Use of systemic antibiotics is prevalent in the treatment of patients with end-stage dementia, despite the limited utility and discomfort associated with the use of these agents.
Study details
- Participants279
- Evidence strengthLow
How this study scored 45/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported 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 and multi-centre collaboration, so those were left out: it earned 26 of the 58 points we could judge it on, which is 45 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Psychiatric services (Washington, D.C.)) |
| 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 | 2002 — older than 20 years, still counted |
| Sample size | 2 / 4 | 279 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 11986512) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 26 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 26 of the 58 points we could judge it on is 45 out of 100. |
| Total | 45 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.
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
Evers, M. M., Purohit, D., Perl, D., Khan, K., & Marin, D. B. (2002). Palliative and aggressive end-of-life care for patients with dementia. Psychiatric services (Washington, D.C.). https://doi.org/10.1176/appi.ps.53.5.609
Vancouver
Evers MM, Purohit D, Perl D, Khan K, Marin DB. Palliative and aggressive end-of-life care for patients with dementia. Psychiatric services (Washington, D.C.). 2002. doi:10.1176/appi.ps.53.5.609. PMID: 11986512.
BibTeX
@article{evers2002-11986512,
author = {Evers, M. M. and Purohit, D. and Perl, D. and Khan, K. and Marin, D. B.},
title = {{Palliative and aggressive end-of-life care for patients with dementia}},
journal = {Psychiatric services (Washington, D.C.)},
year = {2002},
doi = {10.1176/appi.ps.53.5.609},
pmid = {11986512},
url = {https://doi.org/10.1176/appi.ps.53.5.609}
}
Related studies in End-of-life care
Also tagged “care”
996 studies in the library carry the topic tag “care”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 996 tagged studies.