In the accompanying prospective cohort study, Xie and colleagues show that people can live for several years after being diagnosed as having dementia and many are already frail at the time of diagnosis.1 The authors estimated survival times after the onset of dementia in 438 people according to age, self reported health, disability, and severity of cognitive impairment. The estimated median survival time from the onset of dementia was 4.1 years (interquartile range 2.5-7.6) for men and 4.6 years (2.9-7.0) for women. Survival between the youngest (56-69 years) and oldest people (≥90 years) differed by nearly seven years. Sex, age of onset, and disability significantly predicted mortality in the presence of dementia. The study shows that dementia is a terminal condition, the course of which unfolds with coexisting age related impairment and …