Their last 6 months: suffering and survival of end-stage dementia patients.

Objective: to study possible interrelations existing between the Mini-Suffering State Examination (MSSE) scale and survival of end-stage dementia patients.

Methods: a cohort study of 252 end-stage dementia patients with a 6-month follow-up period, conducted in a Division of Geriatric Medicine of a general hospital. We included 134 consecutive bedridden end-stage dementia patients admitted during a 36-month period, and surviving in the ward for <6 months. Interrelations between survival and admission MSSE scores were studied.

Results: compared with patients surviving >/=6 months, those dying within 6 months were significantly older (P = 0.014). Mean survival time was 57.76 +/- 9.73 days for the low MSSE score group (29 patients, MSSE 2.24 +/- 0.99), 44.70 +/- 5.99 days for the intermediate MSSE score group (53 patients, MSSE 4.92 +/- 0.83) and 27.54 +/- 4.16 days for the high MSSE score group (52 patients, MSSE 8.06 +/- 1.00). Differences between the survival times of these three MSSE score groups were statistically significant (Kaplan-Meier Analysis Log Rank P = 0.0018, Breslow P = 0.0027). The Cox proportional hazard model of survival showed a significant interrelation of high MSSE scores and shorter survival (P = 0.013).

Conclusions: documentation of a high-suffering level by the MSSE scale helps in identifying end-stage dementia patients expected to benefit from enrolment into a palliative care setting.