About a third of your remaining life span is spent in a nursing home if you get dementia

Adapted from BMJ 11-18 Jan 2025

Dementia is perhaps the disease we all most dread. It kills you slowly and gradually. You stop being able to learn new things, you forget a lot of your past and relationships, and your personality changes along with your physical abilities.

Bruck CC et al, searched for longitudinal studies on survival and admission to nursing homes, in people who had been diagnosed with dementia. Studies had to include at least 150 people and follow them up for at least a year.

Median survival from diagnosis seemed strongly dependent on age, ranging from 8.9 years, mean age 60 in women to 2.2 years at a mean age 85 for men.

Overall, women survived for fewer years than men, but this was due to them being diagnosed at later ages than men. The mean difference between the sexes was 4.1 years.

Median survival was 1.2 – 1.4 years longer in Asia, than in the US or Europe. My comment: I wonder if this is due to the tendency for older people to be looked after in extended families there.

Survival time with Alzheimer’s disease was 1.4 years longer than with other types of dementia.

One the whole, survival tends to be longer now than it was pre-2000.

The median time to nursing home admission was 3.3 years. 13% of people were admitted in the first year after diagnosis, increasing to 57% after five years. About a third of the time of remaining life expectancy was spent in a nursing home.

These figures are averages, and are potentially helpful when it comes to health and social care planning for governments, health boards and councils. The individual prognosis, however, is highly dependent on personal and clinical characteristics, offering potential for individualised prognostic information and care planning.

My comment: In my work as a GP, I often was consulted by worried relatives about suspected dementia. I would assess the patient, and particularly if I knew the patient well, I could be pretty sure that there had been a definite cognitive deficit, and I would refer to the memory clinic. More often than not, the patient would come back with no diagnosis. 18 months to two years later, I would refer again, and this time the dementia diagnosis would be made. It seems to me that the tests used for diagnosis are not that accurate in getting a diagnosis in the early stages. Dementia symptoms can have a lot in common with other problems such as depression. At the same time, there are still no good treatments for it. There has been a little success with ketogenic diets and ketone supplementation. Meanwhile, what tends to be good for your blood vessels, tends to be good for your brain.