Dementia and Other Competing Risks for Mortality in the Institutionalized Aged*

The relative importance of dementia, gender, age and functional status (FS) was examined for relationships to mortality within five years after admission of the subjects to a New York City nursing home for the aged. Using a random sample of 212 of the nursing home's patients, a statistical model was developed to estimate the relative risk of mortality. When this model was cross-validated on an independent sample of 118 residents, it failed to show significant lack of fit. Given these results, an international model was developed by combining the New York City samples(N = 330) and comparing them to a sample (N = 363) from a nursing home in Tokyo, Japan. In the new York model, gender was the most important predictor, with age and dementia next in importance; FS was not a significant predictor. Despite the apparent differences in the types of dementia in the New York and Tokyo nursing homes, the mortality patterns were similar.