Kurt Kroenke, Sujuan Gao, Susan E Hickman, Alexia M Torke, Nina M Johnson, Amy Pemberton, Andrea Vrobel, Minmin Pan, Laura R Holtz, Greg A Sachs
{"title":"社区环境中晚期痴呆患者的临终症状：来自in - peace的研究结果","authors":"Kurt Kroenke, Sujuan Gao, Susan E Hickman, Alexia M Torke, Nina M Johnson, Amy Pemberton, Andrea Vrobel, Minmin Pan, Laura R Holtz, Greg A Sachs","doi":"10.1016/j.jpainsymman.2025.05.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>The symptom burden in persons dying with advanced dementia outside long-term care facilities has not been well studied.</p><p><strong>Objectives: </strong>To determine the symptom burden in persons dying with advanced dementia in the community setting.</p><p><strong>Methods: </strong>The sample consisted of patient-caregiver dyads enrolled in the 24-month IN-PEACE trial of home-based care management for advanced dementia. Postmortem interviews were administered to caregivers of persons with advanced dementia who had recently died. The primary outcome was the Comfort Assessment in Dying-End of Life in Dementia (CAD-EOLD) scale. A secondary symptom measure was the Symptom Management in End of Life Dementia (SM-EOLD). Results were analyzed and compared to previous studies using the CAD-EOLD.</p><p><strong>Results: </strong>Of the 83 persons with dementia who died during 24 months of follow-up, postmortem caregiver interviews were completed in 80 cases of which 79 completed the CAD-EOLD. Patients' mean age was 83.1; 68% were women, 57% white, and 37% African American. Most patients (62%) died at home and only 32% died in a hospital or nursing home. Hospice enrollment occurred in 75% of participants. Symptom management as reflected in CAD-EOLD scores was comparable to previous studies of persons with dementia dying in nursing homes. Compared to baseline SM-EOLD scores, end-of-life symptom scores were 4 points better. Intervention and control group outcomes were similar.</p><p><strong>Conclusions: </strong>Some community-dwelling persons with advanced dementia can die at home with symptom management comparable to that received in nursing homes.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"End-of-Life Symptoms in Persons Dying with Advanced Dementia in the Community Setting: Findings from IN-PEACE.\",\"authors\":\"Kurt Kroenke, Sujuan Gao, Susan E Hickman, Alexia M Torke, Nina M Johnson, Amy Pemberton, Andrea Vrobel, Minmin Pan, Laura R Holtz, Greg A Sachs\",\"doi\":\"10.1016/j.jpainsymman.2025.05.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>The symptom burden in persons dying with advanced dementia outside long-term care facilities has not been well studied.</p><p><strong>Objectives: </strong>To determine the symptom burden in persons dying with advanced dementia in the community setting.</p><p><strong>Methods: </strong>The sample consisted of patient-caregiver dyads enrolled in the 24-month IN-PEACE trial of home-based care management for advanced dementia. Postmortem interviews were administered to caregivers of persons with advanced dementia who had recently died. The primary outcome was the Comfort Assessment in Dying-End of Life in Dementia (CAD-EOLD) scale. A secondary symptom measure was the Symptom Management in End of Life Dementia (SM-EOLD). Results were analyzed and compared to previous studies using the CAD-EOLD.</p><p><strong>Results: </strong>Of the 83 persons with dementia who died during 24 months of follow-up, postmortem caregiver interviews were completed in 80 cases of which 79 completed the CAD-EOLD. Patients' mean age was 83.1; 68% were women, 57% white, and 37% African American. Most patients (62%) died at home and only 32% died in a hospital or nursing home. Hospice enrollment occurred in 75% of participants. Symptom management as reflected in CAD-EOLD scores was comparable to previous studies of persons with dementia dying in nursing homes. Compared to baseline SM-EOLD scores, end-of-life symptom scores were 4 points better. Intervention and control group outcomes were similar.</p><p><strong>Conclusions: </strong>Some community-dwelling persons with advanced dementia can die at home with symptom management comparable to that received in nursing homes.</p>\",\"PeriodicalId\":16634,\"journal\":{\"name\":\"Journal of pain and symptom management\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of pain and symptom management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jpainsymman.2025.05.004\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpainsymman.2025.05.004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
End-of-Life Symptoms in Persons Dying with Advanced Dementia in the Community Setting: Findings from IN-PEACE.
Context: The symptom burden in persons dying with advanced dementia outside long-term care facilities has not been well studied.
Objectives: To determine the symptom burden in persons dying with advanced dementia in the community setting.
Methods: The sample consisted of patient-caregiver dyads enrolled in the 24-month IN-PEACE trial of home-based care management for advanced dementia. Postmortem interviews were administered to caregivers of persons with advanced dementia who had recently died. The primary outcome was the Comfort Assessment in Dying-End of Life in Dementia (CAD-EOLD) scale. A secondary symptom measure was the Symptom Management in End of Life Dementia (SM-EOLD). Results were analyzed and compared to previous studies using the CAD-EOLD.
Results: Of the 83 persons with dementia who died during 24 months of follow-up, postmortem caregiver interviews were completed in 80 cases of which 79 completed the CAD-EOLD. Patients' mean age was 83.1; 68% were women, 57% white, and 37% African American. Most patients (62%) died at home and only 32% died in a hospital or nursing home. Hospice enrollment occurred in 75% of participants. Symptom management as reflected in CAD-EOLD scores was comparable to previous studies of persons with dementia dying in nursing homes. Compared to baseline SM-EOLD scores, end-of-life symptom scores were 4 points better. Intervention and control group outcomes were similar.
Conclusions: Some community-dwelling persons with advanced dementia can die at home with symptom management comparable to that received in nursing homes.
期刊介绍：
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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