of Work: The purpose of this interagency agreement was to support the collection and analysis of data on cause of death and characteristics of decedents in the last year of life in the planning of the 1992 Pretest and 1993 Main Survey of the 1993 National Mortality Followback Survey (NMFS), conducted by NCHS, CDC. This survey supplements information from death certificates in the vital statistics file with information on characteristics of the decedents obtained from the next of kin or other informant knowledgable about the decedents' last days. The pretest examined approximately 800 deaths of individuals aged 15 years and over who died in 1992. The main survey examined 22,951 deaths of individuals aged 15 years and over who died in 1993. This includes 884 deaths to centenarians. Activities during FY 2001 have been concentrated on data analysis. An analysis comparing the 1986 and 1993 NMFS data explored aggregate change over time in diagnosed dementia over the 7-year period between the two surveys. Mortality rates were computed using data from three sources -- the underlying and multiple causes of death as listed on the death certificate, and questions concerning the lifetime history of dementia diagnosis from the informant interviews. Estimates of morbidity in physical and cognitive function were obtained from the informant interviews. Results showed the lifetime history of dementia among decedents rose with age up age 95 and then declined. The reported lifetime history of dementia was more common in 1993 than in 1986. In 1993 death certificate data continued to underestimate dementia mortality as it did in 1986, although for females the mortality rates were higher in 1993 than in 1986, regardless of the source of ascertainment. Morbidity and disability among the demented decedents did not show increases over the same time period, however. Additional analyses of data from this survey are planned. Areas of concentration for these analyses include the lifetime history of additional geriatric conditions, activity levels for a variety of daily and leisure time activities among very old decedents in the last year of life, and comparisons among centenarian and younger decedents with respect to use of health services near the end of life.
| Foley, Daniel J; Brock, Dwight B; Lanska, Douglas J (2003) Trends in dementia mortality from two National Mortality Followback Surveys. Neurology 60:709-11 |
| Bedford, S; Melzer, D; Guralnik, J (2001) Problem behavior in the last year of life: prevalence, risks, and care receipt in older Americans. J Am Geriatr Soc 49:590-5 |
