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Home › Research › End-of-life care

The advanced dementia prognostic tool: a risk score to estimate survival in nursing home residents with advanced dementia

Mitchell SL, Miller SC, Teno JM, Davis RB, Shaffer ML.. Journal of pain and symptom management, 2010-11-01

This page is alzhub.org's plain-English summary of a published study, not the paper itself. It is generated from the record we hold for this study, sourced and linked below — check the original for the full text and methods.

✓ Peer-reviewed alzhub usefulness score 67 out of 100. End-of-life care

Topic: Risk, prevention and care in population studies

Context Estimating life expectancy is challenging in advanced dementia. Objectives To create a risk score to estimate survival in nursing home (NH) residents with advanced dementia. Methods This was a retrospective cohort study performed in the setting of all licensed U.S. NHs. Residents with advanced dementia living in U.S. NHs in 2002 were identified using Minimum Data Set (MDS) assessments. Mortality data from Medicare files were used to determine 12-month survival. Independent variables were selected from the MDS. Cox proportional hazards regression was used to model survival. The accuracy of the final model was assessed using the area under the receiver operating characteristic curve (AUROC). To develop a risk score, points were assigned to variables in the final model based on parameter estimates. Residents meeting hospice eligibility guidelines for dementia, based on MDS data, were identified. The AUROC assessed the accuracy of hospice guidelines to predict six-month survival. Results Over 12 months, 40.6% of residents with advanced dementia (n=22,405) died. Twelve variables best predicted survival: length of stay, age, male, dyspnea, pressure ulcers, total functional dependence, bedfast, insufficient intake, bowel incontinence, body mass index, weight loss, and congestive heart failure. The AUROC for the final model was 0.68. The risk score ranged from 1 to 32.5 points (higher scores indicate worse survival). Only 15.9% of residents met hospice eligibility guidelines for which the AUROC predicting six-month survival was 0.53. Conclusion A mortality risk score derived from MDS data predicted six-month survival in advanced dementia with moderate accuracy. The predictive ability of hospice guidelines, simulated with MDS data, was poor.

Key findings

Study details

How this study scored 67/100
How this study's score is builtJournal tier 7 of 10; Journal's citation record left out, no data; Study design 7 of 12; Strength of evidence 3 of 5; Peer-review validation 10 of 10; How recent 1 of 5; Sample size 4 of 4; Effect reported 2 of 3; Studied in people 3 of 3; Randomised / blinded 0 of 2; Times cited left out, no data; Citations per year left out, no data; Impact for its field and year left out, no data; Cited by studies here left out, no data; Still being cited left out, no data; Senior author's track record left out, no data; Institution's track record left out, no data; Multi-centre collaboration left out, no data; Indexed in PubMed 2 of 2; Free to read 0 of 2. 39 of the 58 points it could be judged on, which is 67 of 100. Total 67 of 100.39 of the 58 points we could judge = 67 of 100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for 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 39 of the 58 points we could judge it on, which is 67 out of 100.

ComponentPointsWhy
Journal tier 7 / 10 Tier 3 — peer-reviewed journal (Journal of pain and symptom management)
Journal's citation record — / 4 No journal record from OpenAlex — left out of this score
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 1 / 5 2010 — within 20 year(s) of the newest study here
Sample size 4 / 4 22,405 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 — / 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 20621437)
Free to read 0 / 2 Behind a paywall — scores zero
Points 39 / 58 Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 39 of the 58 points we could judge it on is 67 out of 100.
Total 67 / 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

Mitchell, S. L., Miller, S. C., Teno, J. M., Davis, R. B., & Shaffer, M. L. (2010). The advanced dementia prognostic tool: a risk score to estimate survival in nursing home residents with advanced dementia. Journal of pain and symptom management. https://doi.org/10.1016/j.jpainsymman.2010.02.014

Vancouver

Mitchell SL, Miller SC, Teno JM, Davis RB, Shaffer ML. The advanced dementia prognostic tool: a risk score to estimate survival in nursing home residents with advanced dementia. Journal of pain and symptom management. 2010. doi:10.1016/j.jpainsymman.2010.02.014. PMID: 20621437.

BibTeX

@article{mitchell2010-20621437,
  author  = {Mitchell, S. L. and Miller, S. C. and Teno, J. M. and Davis, R. B. and Shaffer, M. L.},
  title   = {{The advanced dementia prognostic tool: a risk score to estimate survival in nursing home residents with advanced dementia}},
  journal = {Journal of pain and symptom management},
  year    = {2010},
  doi     = {10.1016/j.jpainsymman.2010.02.014},
  pmid    = {20621437},
  url     = {https://doi.org/10.1016/j.jpainsymman.2010.02.014}
}

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