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Letters
October 6, 2004

Estimating Prognosis for Nursing Home Residents With Advanced Dementia—Reply

Author Affiliations
 

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(13):1553-1554. doi:10.1001/jama.292.13.1553-b

In Reply: We agree with Dr Álvarez-Fernández that “advanced” dementia does not necessarily mean “terminal” dementia. The objective of our study was to create a risk score to estimate survival among nursing home residents with advanced dementia in order to identify the “terminal” individuals among those with advanced disease. Progressive cognitive dysfunction is the hallmark of dementia. Therefore, in order to select a cohort with advanced disease, we identified residents with dementia who had severe cognitive dysfunction. A Cognitive Performance Score of 5 or 6 has been shown to correlate with severe cognitive impairment in individuals with dementia.1,2

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