DEATH IN DEMENTIA - A STUDY OF CAUSES OF DEATH IN DEMENTIA PATIENTS AND THEIR SPOUSES

The certified cause of death in 455 married dementia patients admitted to a psychogeriatric unit between 1971 and 1986 was studied. The cause of death in 154 spouses of dementia patients who died within the study period was also recorded, and analysed for concordance between patients and spouses. The pattern of mortality was similar for male and female patients. Bronchopneumonia was the most common certified cause of death (40%) in the patient group, and 'non-specific' causes of death accounted for 63% of mortality. The pattern of mortality was significantly different to that in the general population, and non-specific deaths were twice as common in the patient group. Comparison with previous studies shows that the pattern of mortality in dementia patients has remained relatively unchanged over the past 50 years despite alterations in medical practice. Common cause of death between patient and spouse was analysed and no evidence of significant concordance was found, but cause of death among spouses tended to follow the pattern of mortality in patients and was significantly different to that found in the general population. Possible explanations for the unchanging pattern of mortality in dementia are considered, and the case for an intrinsic mechanism of terminal weight loss and decline is discussed.