Determining six-month prognosis among people with dementia living in care homes: a systematic review of prognostic tools.

Background Dementia is a leading cause of death among residents in care home settings internationally. Proactive identification of those approaching end-of-life can support future care planning, respecting preferences. We aimed to synthesise existing literature on prognostic tools designed to predic...

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Publicado en:Age & Ageing Vol. 55; no. 4; pp. 1 - 13
Autores principales: West, Emily, Mulligan, Laura, Paudyal, Prabin, Quinn, Terence J, Burton, Jennifer Kirsty
Formato: Artículo
Publicado: Oxford University Press / USA Apr2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2026
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      pub: Oxford University Press / USA
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        193500083
        10.1093/ageing/afag087
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        atl: Determining six-month prognosis among people with dementia living in care homes: a systematic review of prognostic tools.
      aug:
        au:
          West, Emily
          Mulligan, Laura
          Paudyal, Prabin
          Quinn, Terence J
          Burton, Jennifer Kirsty
        affil:
          Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland, UKDepartment of Medicine for the Elderly, Glasgow Royal Infirmary, Glasgow, Scotland, UK
          Department of Medicine for the Elderly, Glasgow Royal Infirmary, Glasgow, Scotland, UKSchool of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
          Medicine for Older Adults, University Hospital Hairmyres, East Kilbride, UK
          Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland, UKMedicine for Older Adults, University Hospital Hairmyres, East Kilbride, UK
      su:
        Food consumption
        Body weight
        Age distribution
        Nursing care facilities
        Cognition
        Mortality risk factors
        Risk assessment
        Medical information storage & retrieval systems
        Research funding
        CINAHL database
        Functional status
        Systematic reviews
        MEDLINE
        Dementia
        Dementia patients
        Psychology information storage & retrieval systems
      sug:
        subj:
          Food consumption
          Body weight
          Age distribution
          Nursing care facilities
          Cognition
          Nursing Care Facilities (Skilled Nursing Facilities)
          Community care facilities for the elderly
          Mortality risk factors
          Risk assessment
          Medical information storage & retrieval systems
          Research funding
          CINAHL database
          Functional status
          Systematic reviews
          MEDLINE
          Dementia
          Dementia patients
          Psychology information storage & retrieval systems
      keyword:
        care home
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        https://dx.doi.org/10.1093/ageing/afag087
        inLanguage:en
        long-term care
        mortality
        older people
        palliative and end of life care
        patient prognosis
        prognosis
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41965251/
        systematic review
        care home
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        https://dx.doi.org/10.1093/ageing/afag087
        inLanguage:en
        long-term care
        mortality
        older people
        palliative and end of life care
        patient prognosis
        prognosis
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41965251/
        systematic review
      ab: Background Dementia is a leading cause of death among residents in care home settings internationally. Proactive identification of those approaching end-of-life can support future care planning, respecting preferences. We aimed to synthesise existing literature on prognostic tools designed to predict 6-month mortality in individuals with dementia residing in care homes including their content and prognostic performance. Methods A systematic review was undertaken, searching Embase, CINAHL, PsycINFO and MEDLINE in December 2024. Studies evaluating prognostic tools for predicting 6-month mortality in individuals with dementia living in care homes were included. Risk of bias was assessed using the PROBAST tool. Data were extracted and narratively synthesised. Results Thirteen studies involving 503 501 participants were included from a total of 5438 records screened. Eleven prognostic tools were identified. Only three studies were assessed at low risk of bias. Predictive factors per tool ranged from 4 to 12. Age, change in cognitive function, functional decline/dependency and concerns around nutritional intake/weight were the commonest domains of predictors across included tools. Reporting around the discriminative performance of tools was limited and only two tools (Mortality Risk Index Score and Advanced Dementia Prognostic Tool had acceptable discrimination (area under receiver operating curve >0.70), which was not replicated in validation studies. Conclusions While identified predictors have clinical congruence, there is significant variability in how these are assessed and operationalised and in the application of prognostic tools. Specific prediction of mortality remains challenging and would benefit from further research to adapt and validate dynamic prognostic tools for use in practice.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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