More than half of adults diagnosed with dementia die within five years – signaling a need for informed conversations about care, according to the developers of a new prediction tool.

In a study of more than 100,000 people newly diagnosed with dementia, investigators found that certain factors reliably predict five-year outcomes. Older age, being male and the presence of chronic obstructive pulmonary disease, congestive heart failure, and kidney failure at diagnosis are key signs of higher mortality risk. These factors also predict a move to an eldercare facility within that timeframe, reported Peter Tanuseputro, M.D., from the Bruyère Research Institute, Canada.

Among study participants who died, fully 28% had entered an eldercare facility. Only one in four were still alive and living in the community at five years.

Given that the five-year dementia mortality rate is similar to that of many cancers, Tanuseputro and colleagues propose that their simple questions-based prediction tool, now available online, could help long-term care facility residents and their families make decisions about care choices. Often, these conversations don’t happen at all, they said.

“It may be that many would choose care that focuses on comfort care and quality of life should they become acutely ill,” said Tanuseputro, who specializes in palliative care and long-term care research. “For newly diagnosed dementia patients and their families, personalized information about their trajectory may be helpful to plan for the future, including advance care planning and planning for additional supports.”

The study was published in the Canadian Medical Association Journal.