Prevalence of dementia and survival with dementia in people entering residential aged care in Australia: Trends from 2008 to 2014

Objectives: To examine trends in the prevalence of dementia and the survival of those with dementia when entering residential aged care in Australia. Methods: A retrospective study using the national historical cohort of the Registry of Older South Australians (ROSA) was conducted. This cohort includes information on aged care recipients from the National Aged Care Data Clearinghouse linked with National Death Index data. The study sample (2008–2014) included people who started permanent residential care and dementia was identified according to the person’s most recent Aged Care Assessment Team (ACAT) or Aged Care Funding Instrument (ACFI) assessment. Generalized linear models adjusted for age and sex were used to estimate risk of mortality for people with dementia. Results: Between 2008 and 2014, 351,694 people entered residential aged care and had an available ACAT or ACFI assessment. The prevalence of dementia declined by an estimated -0.7% each year (95% confidence interval (CI) -0.8, -0.6, p<0.001) for the overall cohort. One-year mortality rates increased from 2008 to 2014 for people living with dementia for females only (0.2% each year 95%CI 0.1, 0.4, p=0.001). People living with dementia had a lower risk of 30-day, 90-day and one-year mortality (Risk Ratio for one-year mortality (95%CI): 0.86 (0.85, 0.87), p<0.001). Conclusions: In Australia, for people entering residential aged care, dementia prevalence is declining and one-year mortality rates for women living with dementia are increasing. People living with dementia have a reduced risk of death in the first year of entering residential care compared to those without dementia.