Objective: to study possible interrelations existing between the (MSSE) scale and survival of end-stage dementia patients.
Methods: a cohort study of 252 end-stage dementia patients with a 6-month follow-up period, conducted in a Division of Geriatric Medicine of a general hospital. We included 134 consecutive bedridden end-stage dementia patients admitted during a 36-month period, and surviving in the ward for <6 months. Interrelations between survival and admission MSSE scores were studied.
Results: compared with patients surviving ≥6 months, those dying within 6 months were significantly older (P = 0.014). Mean survival time was 57.76 9.73 days for the low MSSE score group (29 patients, MSSE 2.24 0.99), 44.70 5.99 days for the intermediate MSSE score group (53 patients, MSSE 4.92 0.83) and 27.54 4.16 days for the high MSSE score group (52 patients, MSSE 8.06 1.00). Differences between the survival times of these three MSSE score groups were statistically significant (Kaplan–Meier Analysis Log Rank P = 0.0018, Breslow P = 0.0027). The Cox proportional hazard model of survival showed a significant interrelation of high MSSE scores and shorter survival (P = 0.013).
Conclusions: documentation of a high-suffering level by the MSSE scale helps in identifying end-stage dementia patients expected to benefit from enrolment into a palliative care setting.
Keywords: dementia, end-of-life, hospice, suffering, survival, elderly