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To the Editor: Drs Morrison and Siu¹ suggested that patients with advanced dementia may not benefit from hospitalization for hip fracture or pneumonia. However, I am concerned that the authors have grouped together patients with Global Deterioration Scale (GDS)² scores of 6 or 7 and refer to both groups as having "end-stage dementia." They do not report how many of the patients had a GDS score of 6 and how many had a score of 7.

In the original description of the GDS, patients with a score of 6 "may become incontinent and will require travel assistance, but will be able to travel to familiar locations" and "almost always recall their own name, and frequently continue to be able to distinguish familiar from unfamiliar persons in their environment,"² so that although patients with a GDS score of 7 are in a very severe stage of the disease, those with a . . . [Full Text of this Article]

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