Abstract
Objective: to study possible interrelations existing between the Mini-Suffering State Examination (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