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Resource Use During the Last 6 Months of Life of Individuals Dying with and of Alzheimer's Disease

Faes, Kristof ; Cohen, Joachim ; Annemans, Lieven

Journal of the American Geriatrics Society, May 2018, Vol.66(5), pp.879-885 [Peer Reviewed Journal]

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  • Title:
    Resource Use During the Last 6 Months of Life of Individuals Dying with and of Alzheimer's Disease
  • Author: Faes, Kristof ; Cohen, Joachim ; Annemans, Lieven
  • Subjects: Alzheimer'S Disease ; End‐Of‐Life ; Resource Use ; Administrative Database ; Full Population ; Retrospective
  • Is Part Of: Journal of the American Geriatrics Society, May 2018, Vol.66(5), pp.879-885
  • Description: Byline: Kristof Faes, Joachim Cohen, Lieven Annemans Keywords: Alzheimer's disease; end-of-life; resource use; administrative database; full population; retrospective Objectives To compare resource use during the last 6 months of life of individuals diagnosed with Alzheimer's disease (AD) but for whom AD was not formally identified as the underlying cause of death (dying with AD) with that of those who had AD as underlying cause of death (dying of AD). Design Full-population retrospective analysis. Setting Belgium. Participants All Belgian decedents in 2012. Measurements We linked participants' healthcare, population, and death certificate data. Those who died of AD were selected based on underlying cause of death. Those who died with AD were selected using a validated algorithm. Results Individuals who died of AD had less hospital use than those who died with AD; were less often admitted to a palliative care unit but received palliative home care services slightly more often; and had use of physiotherapy, noninvasive ventilation, medical imaging, sedatives, oxygen, and opioids comparable with that of those who died with AD. Conclusion During the last 6 months of life, individuals dying of AD used fewer intensive resources such as intensive care unit, cardiopulmonary resuscitation, and invasive ventilation than those dying with AD, which suggests the effect of recognition of an end-of-life phase. Overall, individuals with AD rarely used palliative care services, suggesting a need for more efforts to encourage use of palliative care in individuals with AD. Supporting information: Additional Supporting Information may be found in the online version of this article Additional Supporting Information may be found in the online version of this article. CAPTION(S): Appendix S1. Causes of Death and Algorithm Explained Figure S1. Resource use and medication use during the last 6 months of life in individuals with Alzheimer's disease Table S1. Multivariate analysis of resource utilization during the last 180, 90, and 30 days of life between those dying with Alzheimer's disease versus dying from
  • Identifier: ISSN: 0002-8614 ; E-ISSN: 1532-5415 ; DOI: 10.1111/jgs.15287

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