The multidimensional prognostic index (MPI), based on a comprehensive geriatric assessment predicts short- and long-term mortality in hospitalized older patients with dementia

Alberto Pilotto, Daniele Sancarlo, Francesco Panza, Francesco Paris, Grazia D'Onofrio, Leandro Cascavilla, Filomena Addante, Davide Seripa, Vincenzo Solfrizzi, Bruno Dallapiccola, Marilisa Franceschi, Luigi Ferrucci

Research output: Contribution to journalArticle

Abstract

Aim of this study was to evaluate the usefulness of a Multidimensional Prognostic Index (MPI) based on a Comprehensive Geriatric Assessment (CGA) for predicting mortality risk in older patients with dementia. The present was a retrospective study with a year of follow-up that included 262 patients aged 65 years and older with a diagnosis of dementia. A standardized CGA that included information on clinical, cognitive, functional, and nutritional aspects, as well as comorbidity, medications, and social support network, was used to calculate MPI. The predictive value of the MPI for all-cause mortality over 1 month, 6 months, and 12 months of follow-up was evaluated. Higher MPI values were significantly associated with higher mortality at 1 month (MPI-1, low risk = 0%, MPI-2, moderate risk = 5.2%, MPI-3, severe risk = 13.7%; p <0.002), 6-months (MPI-1 = 2.7%, MPI-2 = 11.2%, MPI-3 = 28.8%; p <0.001), and 12-months (MPI-1 = 2.7%, MPI-2 = 18.2%, MPI-3 = 35.6%; p <0.001) of follow-up. The discrimination of the MPI was also good, with areas under the ROC curves of 0.77 (sensitivity = 82.9%, specificity = 66.0%, with a cut off value > 0.16) at 12-months of follow up. In conclusion, the MPI, calculated from information collected in a standardized CGA, accurately stratified hospitalized elderly patients with dementia into groups at varying risk of short- and long-term mortality.

Original languageEnglish
Pages (from-to)191-199
Number of pages9
JournalJournal of Alzheimer's Disease
Volume18
Issue number1
DOIs
Publication statusPublished - 2009

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Geriatric Assessment
Dementia
Mortality
Social Support
Comorbidity
Retrospective Studies

Keywords

  • Comprehensive Geriatric Assessment (CGA)
  • Dementia
  • Mortality
  • Multidimensional Prognostic Index (MPI)
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology

Cite this

The multidimensional prognostic index (MPI), based on a comprehensive geriatric assessment predicts short- and long-term mortality in hospitalized older patients with dementia. / Pilotto, Alberto; Sancarlo, Daniele; Panza, Francesco; Paris, Francesco; D'Onofrio, Grazia; Cascavilla, Leandro; Addante, Filomena; Seripa, Davide; Solfrizzi, Vincenzo; Dallapiccola, Bruno; Franceschi, Marilisa; Ferrucci, Luigi.

In: Journal of Alzheimer's Disease, Vol. 18, No. 1, 2009, p. 191-199.

Research output: Contribution to journalArticle

Pilotto, Alberto ; Sancarlo, Daniele ; Panza, Francesco ; Paris, Francesco ; D'Onofrio, Grazia ; Cascavilla, Leandro ; Addante, Filomena ; Seripa, Davide ; Solfrizzi, Vincenzo ; Dallapiccola, Bruno ; Franceschi, Marilisa ; Ferrucci, Luigi. / The multidimensional prognostic index (MPI), based on a comprehensive geriatric assessment predicts short- and long-term mortality in hospitalized older patients with dementia. In: Journal of Alzheimer's Disease. 2009 ; Vol. 18, No. 1. pp. 191-199.
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abstract = "Aim of this study was to evaluate the usefulness of a Multidimensional Prognostic Index (MPI) based on a Comprehensive Geriatric Assessment (CGA) for predicting mortality risk in older patients with dementia. The present was a retrospective study with a year of follow-up that included 262 patients aged 65 years and older with a diagnosis of dementia. A standardized CGA that included information on clinical, cognitive, functional, and nutritional aspects, as well as comorbidity, medications, and social support network, was used to calculate MPI. The predictive value of the MPI for all-cause mortality over 1 month, 6 months, and 12 months of follow-up was evaluated. Higher MPI values were significantly associated with higher mortality at 1 month (MPI-1, low risk = 0{\%}, MPI-2, moderate risk = 5.2{\%}, MPI-3, severe risk = 13.7{\%}; p <0.002), 6-months (MPI-1 = 2.7{\%}, MPI-2 = 11.2{\%}, MPI-3 = 28.8{\%}; p <0.001), and 12-months (MPI-1 = 2.7{\%}, MPI-2 = 18.2{\%}, MPI-3 = 35.6{\%}; p <0.001) of follow-up. The discrimination of the MPI was also good, with areas under the ROC curves of 0.77 (sensitivity = 82.9{\%}, specificity = 66.0{\%}, with a cut off value > 0.16) at 12-months of follow up. In conclusion, the MPI, calculated from information collected in a standardized CGA, accurately stratified hospitalized elderly patients with dementia into groups at varying risk of short- and long-term mortality.",
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AU - Sancarlo, Daniele

AU - Panza, Francesco

AU - Paris, Francesco

AU - D'Onofrio, Grazia

AU - Cascavilla, Leandro

AU - Addante, Filomena

AU - Seripa, Davide

AU - Solfrizzi, Vincenzo

AU - Dallapiccola, Bruno

AU - Franceschi, Marilisa

AU - Ferrucci, Luigi

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