Advanced dementia

State of the art and priorities for the next decade

Susan L. Mitchell, Betty S. Black, Mary Ersek, Laura C. Hanson, Susan C. Miller, Greg A. Sachs, Joan Teno, R. Sean Morrison

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Dementia is a leading cause of death in the United States. This article outlines the current understanding of advanced dementia and identifies research priorities for the next decade. Research over the past 25 years has largely focused on describing the experience of patients with advanced dementia. This work has delineated abundant opportunities for improvement, including greater recognition of advanced dementia as a terminal illness, better treatment of distressing symptoms, increased access to hospice and palliative care services, and less use of costly and aggressive treatments that may be of limited clinical benefit. Addressing those opportunities must be the overarching objective for the field in the coming decade. Priority areas include designing and testing interventions that promote high-quality, goal-directed care; health policy research to identify strategies that incentivize cost-effective and evidencebased care; implementation studies of promising interventions and policies; and further development of disease-specific outcome measures. There is great need and opportunity to improve outcomes, contain expenditures, reduce disparities, and better coordinate care for the millions of persons in the United States who have advanced dementia.

Original languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalAnnals of internal medicine
Volume156
Issue number1
StatePublished - Jan 3 2012
Externally publishedYes

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Dementia
Research
Hospice Care
Health Expenditures
Health Policy
Palliative Care
Cause of Death
Outcome Assessment (Health Care)
Costs and Cost Analysis
Therapeutics

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Mitchell, S. L., Black, B. S., Ersek, M., Hanson, L. C., Miller, S. C., Sachs, G. A., ... Sean Morrison, R. (2012). Advanced dementia: State of the art and priorities for the next decade. Annals of internal medicine, 156(1), 45-51.

Advanced dementia : State of the art and priorities for the next decade. / Mitchell, Susan L.; Black, Betty S.; Ersek, Mary; Hanson, Laura C.; Miller, Susan C.; Sachs, Greg A.; Teno, Joan; Sean Morrison, R.

In: Annals of internal medicine, Vol. 156, No. 1, 03.01.2012, p. 45-51.

Research output: Contribution to journalArticle

Mitchell, SL, Black, BS, Ersek, M, Hanson, LC, Miller, SC, Sachs, GA, Teno, J & Sean Morrison, R 2012, 'Advanced dementia: State of the art and priorities for the next decade', Annals of internal medicine, vol. 156, no. 1, pp. 45-51.
Mitchell SL, Black BS, Ersek M, Hanson LC, Miller SC, Sachs GA et al. Advanced dementia: State of the art and priorities for the next decade. Annals of internal medicine. 2012 Jan 3;156(1):45-51.
Mitchell, Susan L. ; Black, Betty S. ; Ersek, Mary ; Hanson, Laura C. ; Miller, Susan C. ; Sachs, Greg A. ; Teno, Joan ; Sean Morrison, R. / Advanced dementia : State of the art and priorities for the next decade. In: Annals of internal medicine. 2012 ; Vol. 156, No. 1. pp. 45-51.
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