Life events and survival in dementia: a 5-year follow-up study


  • Rob Butler, Clinical Lecturer (Correspondence)

    Department of Psychiatry, University of Auckland, Auckland, New Zealand. Email:

    Martin Orrell, Professor; Paul Bebbington, Professor

    Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London, UK

    Obioha C. Ukoumunne, MRC Fellow

    Department of Public Health Sciences, King's College London, London, UK

Rob Butler, Clinical Lecturer (Correspondence)


Objectives:  To examine the relationship between life events and survival for people with dementia. To investigate whether this relationship differs from that for people without dementia. To identify which psychiatric and social factors are associated with survival in people with dementia.

Method:  A prospective cohort study with external controls. One hundred and sixteen people with dementia and 50 fit, elderly controls were assessed for life events over a 6-month period. They were followed-up at 5 years and data collected on length of survival.

Results:  There was an association between two or more severe life events and reduced survival. This association appeared stronger for controls than people with dementia although the interaction was not significant (p = 0.052). The only psychiatric or social factor associated with poor survival in dementia was depression. Other factors associated with reduced survival in the dementia group were male sex, older age, poor physical health, later age of onset and a poorer level of functioning.

Conclusions:  This study provides some evidence that having two or more stressful and negative life events may reduce survival in older people with and without dementia. If replicated, this finding will have implications for our understanding of the clinical course of dementia.