A systematic review of the current prognostic tools used to predict the survival length of people living with advanced dementia.
Palliat MedJul 31, 2026 (epub)
Abigail Maughan, Andrea Bruun, Nuriye Kupeli et al.
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In 30 seconds
This systematic review evaluated prognostic tools for estimating survival in individuals with advanced dementia, analyzing data from 225,553 patients across various settings. The review identified six tools, with the PRO-MADE model showing the highest discrimination (AUC 0.76). However, the tools exhibited limited accuracy and high risk of bias.
Key findings
- Six prognostic tools were identified across seven studies involving 225,553 individuals with advanced dementia.
- The PRO-MADE model had the highest discrimination with an AUC of 0.76.
- AUC values for the tools ranged from 0.55 to 0.76, indicating inconsistent accuracy.
- Five studies showed a high risk of bias due to methodological limitations.
Why it matters
Accurate prognostication in advanced dementia is crucial for timely palliative care. Understanding the limitations of current tools can guide clinicians in making informed decisions regarding end-of-life care.
What to keep in mind
Five studies demonstrated high risk of bias due to methodological limitations and lack of external validation.