Sex-Specific Differences in End-of-Life Burdensome Interventions and Antibiotic Therapy in Nursing Home Residents With Advanced Dementia

Key Points Question What are the population-based frequency, factors, and sex-specific differences in burdensome interventions and antibiotic therapy at the very end of life among nursing home residents with advanced dementia? Findings In this population-based cohort study of 27 243 decedent nursing home residents with advanced dementia, men were statistically significantly more likely than women to experience burdensome interventions (ie, transitions of care, invasive procedures, and physical restraints) and receive antibiotics; only a minority of residents saw a palliative care physician in the year before death, but those who did were significantly less likely to experience an end-of-life transition of care and to receive antibiotics. Meaning Study findings underscore the importance of sex-specific analysis in dementia research and the expanding roles of palliative care and antimicrobial stewardship in the nursing home setting.