Time to nursing home admission and death in people with dementia: systematic review and meta-analysis
Abstract
Abstract Objective To summarise available evidence on time to nursing home admission and death among people with dementia, and to explore prognostic indicators. Design Systematic review and meta-analysis. Data sources Medline, Embase, Web of Science, Cochrane, and Google Scholar from inception to 4 July 2024. Eligibility criteria for selecting studies Longitudinal studies on survival or nursing home admission in people with dementia. Studies with fewer than 150 participants, recruitment during acute hospital admission, or less than one year of follow-up were excluded. Results 19 307 articles were identified and 261 eligible studies included. 235 reported on survival among 5 553 960 participants and 79 reported on nursing home admission among 352 990 participants. Median survival from diagnosis appeared to be strongly dependent on age, ranging from 8.9 years at mean age 60 for women to 2.2 years at mean age 85 for men. Women overall had shorter survival than men (mean difference 4.1 years (95% confidence interval 2.1 to 6.1)), which was attributable to later age at diagnosis in women. Median survival was 1.2 to 1.4 years longer in Asia than in the US and Europe, and 1.4 years longer for Alzheimer’s disease compared with other types of dementia. Compared with studies before 2000, survival was longer in contemporary clinic based studies (Ptrend=0.02), but not in community based studies. Taken together, variation in reported clinical characteristics and study methodology…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 352 participants or records.
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