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Observational Study
. 2019 Dec 27;9(1):20235.
doi: 10.1038/s41598-019-56388-w.

Place of death trends among patients with dementia in Japan: a population-based observational study

Toshihiro Koyama  1 , Misato Sasaki  2 , Hideharu Hagiya  3 , Yoshito Zamami  4 , Tomoko Funahashi  5 , Ayako Ohshima  2 , Yasuhisa Tatebe  6 , Naoko Mikami  7 , Kazuaki Shinomiya  8 , Yoshihisa Kitamura  6 , Toshiaki Sendo  6 , Shiro Hinotsu  9 , Mitsunobu R Kano  5   10
Affiliations
Observational Study

Place of death trends among patients with dementia in Japan: a population-based observational study

Toshihiro Koyama et al. Sci Rep. .

Abstract

Dementia is a major public health concern in ageing societies. Although the population of Japan is among the most aged worldwide, long-term trends in the place of death (PoD) among patients with dementia is unknown. In this Japanese nationwide observational study, we analysed trends in PoD using the data of patients with dementia who were aged ≥65 years and died during 1999-2016. Trends in the crude death rates and PoD frequencies were analysed using the Joinpoint regression model. Changes in these trends were assessed using the Joinpoint regression analysis in which significant change points, the annual percentage change (APC) and average APCs (AAPC) in hospitals, homes, or nursing homes were estimated. During 1999-2016, the number of deaths among patients with dementia increased from 3,235 to 23,757 (total: 182,000). A trend analysis revealed increased mortality rates, with an AAPC of 8.2% among men and 9.3% among women. Most patients with dementia died in the hospital, although the prevalence of hospital deaths decreased (AAPC: -1.0%). Moreover, the prevalence of nursing home deaths increased (AAPC: 5.6%), whereas the prevalence of home deaths decreased (AAPC: -5.8%). These findings support a reconsideration of the end-of-life care provided to patients with dementia.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Trends in the crude mortality rates associated with dementia per 100,000 people aged ≥65 years by sex during 1999–2016.
Figure 2
Figure 2
Trends in the crude mortality rates associated with dementia per 100,000 people aged ≥65 years by age during 1999–2016.
Figure 3
Figure 3
Trends in the prevalence rates of places of death among dementia patients aged ≥65 years by age during 1999–2016.
Figure 4
Figure 4
Trends in the prevalence rates of places of death among dementia patients aged ≥65 years by sex during 1999–2016.
See this image and copyright information in PMC

References

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    1. Ministry of Health, Labour, and Welfare. Patient survey. https://www.mhlw.go.jp/english/database/db-hss/ps.html (Accessed September 20th, 2019).

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