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To describe the clinical course of patients with advanced dementia, researchers conducted this prospective study of 323 patients (mean age, 85) who resided in 22 nursing homes in or near Boston. All patients had advanced dementia with profound cognitive deficits (e.g., inability to recognize family members, minimal verbal communication, total functional dependence), and all had healthcare proxies (usually the patients' children).
During 18 months of observation, 41% of patients developed pneumonia, 53% experienced febrile episodes (excluding pneumonia), 86% had eating problems (e.g., reduced intake, dysphagia), and 55% died. Pain, dyspnea, pressure ulcers, and aspiration were common. Among patients who died, 41% underwent what investigators …