Dementia

Example of a completed Medical Certificate of Cause of Death. The certificate contains 6 lines for completion separated into two parts. Part 1, line A for the disease or condition leading directly to death. Part 1 lines B, C, D and E for antecedent causes which are morbid conditions, if any, giving rise to the above cause, stating the underlying condition last. Part 2 of the certificate is a single line for other significant conditions contributing to the death but not directly related to the disease or condition causing it. For both Part 1 and Part 2 there is a column to record the approximate interval between onset and death for the conditions on each line. 

The certificate is filled out as follows: 

• Part 1(a): Aspiration pneumonia. Approximate interval between onset and death: 5 days
• Part 1(b): Alzheimer’s and vascular dementia. Approximate interval between onset and death: 6 years
• Parts 1(c), 1(d) and 1(e): Blank. Approximate interval between onset and death: Blank
• Part 2: Bedbound, recurrent infections from pressure sores. Approximate interval between onset and death: 4 months, 4 months

Example of a completed Medical Certificate of Cause of Death. The certificate contains 6 lines for completion separated into two parts. Part 1, line A for the disease or condition leading directly to death. Part 1 lines B, C, D and E for antecedent causes which are morbid conditions, if any, giving rise to the above cause, stating the underlying condition last. Part 2 of the certificate is a single line for other significant conditions contributing to the death but not directly related to the disease or condition causing it. For both Part 1 and Part 2 there is a column to record the approximate interval between onset and death for the conditions on each line. 

The certificate is filled out as follows: 

• Part 1(a): Staphylococcus aureus urosepsis. Approximate interval between onset and death: 1 day
• Part 1(b): Urinary tract infection from indwelling catheter. Approximate interval between onset and death: 2 weeks
• Part 1(b): Urinary retention. Approximate interval between onset and death: 2 months
• Part 1(d): Mixed dementia: Alzheimer’s and Lewy body dementia. Approximate interval between onset and death: 10 years
• Part 1(e): Blank. Approximate interval between onset and death: Blank
• Part 2: Delirium. Approximate interval between onset and death: 7 days