TY - JOUR
T1 - Place of death trends among patients with dementia in Japan
T2 - a population-based observational study
AU - Koyama, Toshihiro
AU - Sasaki, Misato
AU - Hagiya, Hideharu
AU - Zamami, Yoshito
AU - Funahashi, Tomoko
AU - Ohshima, Ayako
AU - Tatebe, Yasuhisa
AU - Mikami, Naoko
AU - Shinomiya, Kazuaki
AU - Kitamura, Yoshihisa
AU - Sendo, Toshiaki
AU - Hinotsu, Shiro
AU - Kano, Mitsunobu R.
N1 - Funding Information:
ethics approval. This study used data provided by the Japanese Ministry of Health, Labour, and Welfare and the Statistics Bureau of the Ministry of Internal Affairs and Communications. Because these data are fully anonymised and available to the public, the ethics committee of Okayama University Hospital deemed that there was no requirement for a formal ethical review. This study was an observational study based on anonymised information, with no treatment intervention and no collection of human samples. Therefore, the requirement to obtain informed consent was waived.
Funding Information:
We would like to thank Editage (www.editage.jp) for English language editing. This publication was supported by Japan Society for the Promotion of Science KAKENHI (19K10533) (Tokyo, Japan).
Publisher Copyright:
© 2019, The Author(s).
PY - 2019/12/1
Y1 - 2019/12/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85077337171&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077337171&partnerID=8YFLogxK
U2 - 10.1038/s41598-019-56388-w
DO - 10.1038/s41598-019-56388-w
M3 - Article
C2 - 31882673
AN - SCOPUS:85077337171
VL - 9
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
IS - 1
M1 - 20235
ER -