BACKGROUND: After diagnosis of a health condition, information about sur vival and potential transition from com munity into institutional care can be helpful for patients and care providers. We sought to describe the association between a new diagnosis of dementia and risk of admission to a longterm care home and death at 5 years. METHODS:We conducted a population based retrospective cohort study using linked health administrative databases. We identified individuals aged 65 years or older, living in the community, with a first documented diagnosis of dementia between Jan. 1, 2010, and Dec. 31, 2012, in Ontario, Canada. Dementia diagnosis was captured using diagnostic codes RESULTS: We identified 108 757 individ uals in our study cohort. By the end of 5 years, 24.4% remained alive in the com munity and 20.5% were living in a long term care home. Of the 55.1% who died, about half (27.9%) were admitted to a longterm care home before death. Three risk factors were associated with increased odds of death: older age (age ≥ 90 yr; odds ratio [OR] 9.5, 95% confidence interval [CI] 8.8-10.2 [reference: age 65-69 yr]), male sex (OR 1.7, 95% CI 1.6-1.7), and the pres ence of organ failure, including chronic obstructive pulmonary disease (OR 1.7, 95% CI 1.7-1.8), congestive heart failure (OR 2.0, 95% CI 1.9-2.0) and renal failure (OR 1.7, 95% CI 1.6-1.8). Groups formed by combinations of these 3 factors had an observed 5year risk of death varying between 22% and 91%.