Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2015 Sep 24;373(13):1276-7.
doi: 10.1056/NEJMc1509349.

Advanced Dementia

Susan L Mitchell
Comment

Advanced Dementia

Susan L Mitchell. N Engl J Med. .

Abstract

An 89-year-old male nursing home resident with a 10-year history of Alzheimer’s disease presents with a temperature of 38.3°C, a productive cough, and a respiratory rate of 28 breaths per minute. Nurses report that for the past 6 months he has been coughing at breakfast and having trouble swallowing. He has profound memory deficits, no longer recognizes his daughter (who is his health care proxy), is bedbound, is able to mumble a couple of words, and is unable to perform any activities of daily living. The nurse asks whether he should be hospitalized. How should this patient be evaluated and treated?

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Comment on

  • CLINICAL PRACTICE. Advanced Dementia.
    Mitchell SL. Mitchell SL. N Engl J Med. 2015 Jun 25;372(26):2533-40. doi: 10.1056/NEJMcp1412652. N Engl J Med. 2015. PMID: 26107053 Free PMC article. Review.
  • Advanced Dementia.
    Jenkins I. Jenkins I. N Engl J Med. 2015 Sep 24;373(13):1275-6. doi: 10.1056/NEJMc1509349. N Engl J Med. 2015. PMID: 26398085 No abstract available.
  • Advanced Dementia.
    Warrillow S, Moran J, Weickhardt A. Warrillow S, et al. N Engl J Med. 2015 Sep 24;373(13):1276. doi: 10.1056/NEJMc1509349. N Engl J Med. 2015. PMID: 26398086 No abstract available.

References

    1. Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology. 2013;80:1778–83. - PMC - PubMed
    1. Deaths: preliminary data for 2011. Natl Vital Stat Rep. 2011;61(6):1–51. - PubMed
    1. Weuve J, Hebert LE, Scherr PA, Evans DA. Deaths in the United States among persons with Alzheimer’s disease (2010–2050) Alzheimers Dement. 2014;10(2):e40–e46. - PMC - PubMed
    1. Todd S, Barr S, Roberts M, Passmore AP. Survival in dementia and predictors of mortality: a review. Int J Geriatr Psychiatry. 2013;28:1109–24. - PubMed
    1. Arrighi HM, Neumann PJ, Lieberburg IM, Townsend RJ. Lethality of Alzheimer disease and its impact on nursing home placement. Alzheimer Dis Assoc Disord. 2010;24:90–5. - PubMed