Aims
In this descriptive study, we aimed to investigate 5-year mortality of patients referred to a Melbourne-based memory clinic, and to evaluate risk factors associated with mortality in this cohort.
Methods
Three-hundred and three consecutive patients presenting to the Cognitive, Dementia and Memory Service (CDAMS) at the Royal Melbourne Hospital between July 2016 and October 2018 were included. Using the Electronic Medical Record (linked to government death register), we identified patients who had died within 5 years of initial presentation to the clinic. Other data collected included baseline clinical characteristics and final diagnosis.
Results
The mean age at initial assessment was 78.7 years (SD 8.3) and 168/303 (55.5%) of patients were female. One-hundred and eleven patients (36.6%) died within 5 years of initial assessment, with an average age at death of 84.2 years (SD 6.6). A diagnosis of dementia was made in 172/303 patients (56.8%). Of the group diagnosed with dementia, 72/172 (41.9%) died within 5 years of initial assessment, compared to 39/131 (29.8%) of the non-dementia group (p=0.03, chi-square test). Patients who died were older at presentation (mean 81.7 vs 77.0 years, p=<0.0001, Mann-Whitney U test) and had higher Charlson Comorbidity Index (median 5 vs 4, p=<0.0001, Mann-Whitney U test).
Conclusions
The 5-year mortality of patients assessed at our outpatient cognitive evaluation service is comparable to that of serious chronic health conditions including heart disease and cancer. These results highlight the importance of careful consideration of prognosis and patient values during the diagnostic and post-diagnostic process.