Delirium

Delirium usually clears within a week but can last up to a month. It is associated with a high mortality. The prognosis depends upon successful treatment of the causative illness and the underlying state of the brain. 15% of the elderly do not survive. 40% are in institutional care at 6 months.

N/A

Dementia

With some exceptions, dementia is an irreversibly declining condition. The time from onset to death varies according to the type of dementia.

Indefinite award

Alzheimer’s disease

On average, people spend several years in the mild or minimal stages (although it can be as long as 5 to 10 years), between 4 and 5 years in the moderate stages, and up to a year in the final stage.

Vascular dementia

Characteristically there is stepwise progression. The course varies but can be as severe and rapid as Alzheimer’s disease despite treatment of the underlying cause.

Dementia with Lewy Bodies (DLB)

Similar to Alzheimer’s disease. In the later stages an akinetic-rigid syndrome can cause severe disability in mobility and swallowing and increase the number of falls.

Fronto-temporal dementia (Pick’s disease)

The disease is progressive and the average time from onset to death is between 5 and 10 years.

Prion diseases

Both Variant Creutzfeldt-Jacob disease (vCJD) and Creutzfeldt-Jacob disease (CJD) have poor prognoses. The average time from onset to death is 14 months for vCJD and 4 months for CJD.

Huntington’s disease

Death is usually within 15 years of onset of Huntington’s disease.

Head Injury:

- Causing cognitive impairment

- Causing sensori-motor impairment

- Causing cognitive & sensori-motor impairment

For people with a minor head injury at 3-month follow-up, 79% still have headache, 59% have symptomatic memory disturbance and 34% have not returned to work.

For people with a moderate head injury 63% remain disabled at 1 year.

For people with a severe head injury, 85% remain disabled at 1 year.

The majority of physical recovery occurs in the first 12 months (mostly in the first 6 months) but psychological recovery can take up to 2 years and further small changes can take place over five years or more from the date of injury.

Life expectancy of severely disabled survivors appears to be reduced by about 5 years. However, those who are very dependent may be at increased risk of respiratory complications, resulting in a decrease in life expectancy of 10 years. For people in vegetative state the mean survival rate is 3 - 4 years. For people with severe head injury follow up studies (2 to 10 years post injury) have demonstrated that the long term effects and rehabilitation needs are often extensive as detailed below.

• Independence - Approximately one half is ultimately able to live independently, one quarter live independently with support services and/or are in sheltered accommodation, one quarter are fully dependent upon the family or an institution.

• Occupation - Approximately two thirds are unemployed.

• Leisure and social life - Half report limited contact with friends. Sixty percent have no boyfriend or girlfriend. Many therefore remain dependent upon others, including family members for their leisure and social life.

• Marital relationships - One study of people with very severe head injury demonstrated that very few relationships remained intact at 10-15 year follow-up.

Less than 2 years

More than 2 years

2 year award

Indefinite award