Dementia and Other Risk Factors for Mortality in the Institutionalized Japanese Elderly

In order to evaluate the risk factors on the mortality of the institutionalized Japanese elderly, the cohort study was carried out. We studied the outcome of 114 residents in a skilled nursing home for the elderly in Fukuoka, Japan. Sixty-seven of the residents were demented. During the five-and-a-half year follow-up, the survival rate was lower in the residents with than in those without dementia. (31% vs. 70%). In a univariate analysis, the risk for death increased when factors such as age or systolic blood pressure increased, while it decreased when factors such as the score of Hasegawa's dementia rating scale, the serum albumin level or the activity of daily living score increased. The existence of hypertension, cancer or dementia increased the risk for death, while the ability to urinate and have bowel movements by oneself or that to take meals by oneself decreased it. In a multivariate analysis, dementia, old age, high systolic blood pressure, cancer and the inability to take meals by oneself were risk factors for mortality. Since the treatment of hypertension may sometimes accelerate dementia and limit activities of daily living through a further decreased cerebral blood flow after a blood pressure fall, it seems to be advisable to avoid an excessive blood pressure fall while the treatment of hypertension may be recommended in the elderly. J Epidemiol. 1995; 5 : 117-123.