{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:02:13Z","timestamp":1784383333626,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify predictors of mortality in people with active and challenging behavioral and psychological symptoms of dementia (BPSD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective case\u2013control study was designed to compare those referred to Dementia Support Australia (DSA) who died in the 12\u2009months to November 2016, with an equal number of controls who did not die. An audit tool was designed after literature review and expert opinion from the service. Odds ratio calculations and the Mann\u2013Whitney U test were used to assess for difference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Residents of Australian residential aged care facilities with BPSD referred to the DSA service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Of 476 patients referred to DSA during the study period, 44 died. 44 controls were randomly selected from those remaining matched for age and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant differences included higher rates of benzodiazepine use, drowsiness, delirium, reduced oral intake and discussions about goals of care in those who died. Those who died were referred to the service for a shorter period and had more frequent contact between DSA and nurses at the nursing homes. Increase in opioid use and loss of skin integrity in those who died approached significance. The overall end of life course demonstrated a complex set of needs with frequent delirium, pain and frailty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Further study is required to determine the optimal care for those with BPSD at the end of their lives. This study would indicate complex end of life care needs and point to a role for palliative care support.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1091771","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T04:40:40Z","timestamp":1684125640000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Dying with behavioral and psychological symptoms of dementia in Australian nursing homes: a retrospective case-control study"],"prefix":"10.3389","volume":"14","author":[{"given":"Peter","family":"Roach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie R.","family":"Lovell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Macfarlane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,15]]},"reference":[{"key":"ref1","volume-title":"Australia's Leading Causes of Death, 2016","year":"2017"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"CD011513","DOI":"10.1002\/14651858.CD011513.pub2","article-title":"Palliative care interventions in advanced dementia","volume":"12","author":"Murphy","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1177\/0269216315570411","article-title":"Pain management at the end of life: a comparative study of cancer, dementia, and chronic obstructive pulmonary disease patients","volume":"29","author":"Romem","year":"2015","journal-title":"Palliat Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"CD007132","DOI":"10.1002\/14651858.CD007132.pub2","article-title":"Interventions for improving palliative care for older people living in nursing care homes","volume":"3","author":"Hall","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.1111\/jgs.17802","article-title":"Hospice interventions for persons living with dementia, family members and clinicians: a systematic review","volume":"70","author":"Lassell","year":"2022","journal-title":"J Am Geriatr Soc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1192\/bjp.bp.114.148403","article-title":"Longitudinal course of behavioural and psychological symptoms of dementia: systematic review","volume":"209","author":"van der Linde","year":"2016","journal-title":"Br J Psychiatry"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1192\/bjp.bp.108.049619","article-title":"Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population","volume":"194","author":"Savva","year":"2009","journal-title":"Br J Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1002\/gps.382","article-title":"Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors","volume":"16","author":"Brodaty","year":"2001","journal-title":"Int J Geriatr Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.1177\/02692163211025457","article-title":"Defining end of life in dementia: a systematic review","volume":"35","author":"Browne","year":"2021","journal-title":"Palliat Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1192\/bjp.bp.114.153684","article-title":"Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review","volume":"208","author":"Feast","year":"2016","journal-title":"Br J Psychiatry"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"655254","DOI":"10.3389\/fpsyt.2021.652254","article-title":"Evaluating the clinical impact of national dementia behaviour support programs on neuropsychiatric outcomes in Australia","volume":"12","author":"Macfarlane","year":"2021","journal-title":"Fron Psychiatry"},{"key":"ref12","volume-title":"Rank Score Tests. 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