In a meta-analysis, median survival was 4.8 years; survival was longer for younger patients and for women.

Patients with dementia and their caregivers often seek prognostic information to guide expectations and care planning, but current estimates regarding survival and functional independence vary widely. Researchers conducted a systematic review and meta-analysis of 261 longitudinal studies of survival or nursing home admission in five million people who were followed for at least one year after receiving dementia diagnoses.

Findings were as follows:

• median survival after diagnosis was 4.8 years.
• among women, median survival after diagnosis was 8.9 years at age 60 years and 4.5 years at age 85 years; among men, it was 6.5 and 2.2 years, respectively.
• losses in life expectancy were much greater after receiving a diagnosis at a younger age (13 years’ loss at age 65 years versus two years’ loss at age 85 years).
• median time to nursing home admission was 3.3 years and was significantly shorter in patients who received diagnoses at older ages (0.3 years shorter per year increase in age), with no differences by sex.
• survival was somewhat longer in patients with Alzheimer’s disease than in those with other forms of dementia.

Comment: Although individual outcomes vary widely, these median survival estimates by age and sex might help patients and families set realistic expectations and plan effectively after a dementia diagnosis. Data on nursing home admissions were less reliable than data on survival because of methodological challenges and the influence of socioeconomic variables.

Bruce Soloway, MD, Associate Professor Emeritus of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.

Brück CC, et al. Time to nursing home admission and death in people with dementia: systematic review and meta-analysis. BMJ 2025; 388: e080636.

This summary is taken from the following Journal Watch titles: General Medicine, Neurology, Ambulatory Medicine.