Image of an elderly nursing home resident receiving help with feeding by a nursing assistant

Community-dwelling individuals with severe dementia and disability have a life expectancy of approximately 1.7 years, according to a new analysis of Medicare claims-based data. This knowledge may help patients, caregivers and policy makers to anticipate supportive needs, the researchers say.

Investigators used the National Health and Aging Trends Study, linked to Medicare claims, and identified 842 participants aged 65 years and older with dementia and severe disability. The researchers estimated time to death based on the timing of meeting severe disability criteria, which was defined as three impairments in activities of daily living. 

Fully 80% of participants died during the study period, and the overall predicted median time of death was 1.7 years. Among those in the 75th (highest) percentile of time to death, the mean was 3.8 years. For individuals in the 25th (lowest) percentile, expectancy was 0.6 years.

Notably, there were six characteristics associated with shorter life expectancy in severe dementia. These included older age (specifically 90 years old and older), being bed-bound, being homebound; and having comorbid cancer, unintended weight loss and comorbid depression, the researchers said.

Full findings were published in JAMDA.