Do People Die of Dementia?

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Good morning, welcome to Dementia Q&A. I’m Dr. Marc, internist and geriatrician.

This week’s question: Do people actually die of dementia?

It’s an excellent question. When people think about dementia, often Alzheimer’s disease, they know that the time between a diagnosis and someone’s death can be five, 10, even 15 years. And yet, we tell people that dementia is a terminal diagnosis.

How to put those two things together is not always intuitive. The short answer is yes, people die of dementia all the time, in fact, it’s probably more common than you think. What I want to do is take you through the numbers quickly and then give you one or two examples of how medical professionals connect the diagnosis of dementia to someone’s eventual cause of death.

According to the CDC, dementia is now the fifth most common cause of mortality in America today. That’s after cardiovascular disease, cancer, chronic lung disease and stroke. While the mortality for those four diseases are actually going down gradually, which is great news, the mortality rates for dementia are actually going up gradually, nearly 7% in the last five years alone. In fact, one’s chances of dying of dementia increase greatly from age 65 to 85, nearly 50 times more likely one will have died of dementia at age 85, compared to 65 or 70.

Remember that dementia is a disease of both the body and the mind, not just a disease of the brain. Over time, dementia has more and more effects on what one’s body can and cannot do. So, here are some examples of how someone with advanced dementia, after many, many years, might end up dying of that disease.

Someone with advanced dementia often stops being able to get around. They’re less able to walk, they’re less able to get out of bed and stay active. Often, they actually become bed-bound. If someone who’s bed-bound with late-stage dementia has a blood clot that travels to the lungs, that can kill them. When that happens, it was the dementia that caused that person to be bed-bound and immobile. The blood clot was only a result of that immobility. Therefore, it was the dementia that caused that person’s death initially.

Same thing goes for many types of infections. Here’s an example of that. People with late-stage dementia often can’t swallow effectively and they start to aspirate parts of food or just their own saliva down from the back of the mouth into the lungs. That causes infections, pneumonia, in fact, it can cause multiple pneumonias. People often try to put in feeding tubes, thinking it’ll stop these aspirations, but it actually doesn’t work and the aspirations continue, the pneumonias continue. If someone develops these pneumonias and dies, it was actually really all caused by the dementia and so, dementia is the cause of death for that person. And that’s how medical professionals think about it and link dementia as the true cause of death on someone’s death certificate, which they might have to fill out after someone dies.

I hope that this understanding of how folks with advanced dementia can eventually die of this dementia is helpful to you as you think about someone you might know who passed away from dementia or you’re caring for loved ones with advanced-stage disease.

If you have questions about dementia you’d like a geriatrician to try to answer, please put in the comments section and if you liked or shared or subscribed to the page, it’s greatly appreciated.

Thank you so much for watching this week and I’ll see you all next week.

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