Epidemiological evolution and healthcare services utilization in elderly dementia patients of Catalonia

Abstract

Evolució Epidemiològica; Utilització de Serveis Sanitaris; Demència en Persones Grans

Epidemiological Evolution; Healthcare Services Utilization; Dementia in Elderly Patients

Evolución Epidemiológica; Utilización de Servicios Sanitarios; Demencia en Personas Mayores

Assessing the dynamics and burden of dementia is necessary to improve healthcare plans. This study aimed to describe the epidemiology and characteristics of dementia diagnoses in Catalonia (North-East of Spain) and evaluate healthcare services utilization and associated expenditures in people with dementia compared with people without.

Retrospective study including all the dementia population (2013–2020) using data from an administrative database, the Catalan Health Surveillance System, covering a 7.5–7.7-million population. Data included demographic, clinical, healthcare services utilization, and morbidity-associated risk variables, and was analyzed according to dementia type, including Alzheimer’s disease (AD), vascular dementia (VD), frontotemporal dementia (FTD), dementia with Lewy bodies (LBD), and unspecified dementia (UD). We compared comorbidities and morbidity-associated risk, healthcare services utilization and associated expenditures, and mortality rates between people with dementia and the population without dementia adjusted for age, sex, and income level.

During the study period, dementia prevalence remained stable, and incidence modestly decreased. AD and VD incidence rates decreased, whereas UD modestly increased, being the highest in 2019. Patients with dementia had a higher prevalence of comorbidities, morbidity-associated risk, healthcare services utilization, specially admissions in nursing homes and intermediate care, healthcare-associated expenditures, and mortality than people without dementia adjusted by age, sex, and income level in 2019. An expenditure €1311.7 per person per year was attributable to dementia, representing an increase of 44.1% of total healthcare costs. Compared to other dementia types, AD and VD had increased admissions, and VD had the highest expenditures. The use of antidepressants and benzodiazepines progressively decreased.

Using a population dataset, this study showed that dementia is associated with a high burden and healthcare needs, providing useful information to design improved healthcare plans.

The online version contains supplementary material available at 10.1186/s12889-025-24341-4.

This study was funded by 2020 strategies from the Ministry of Health, which were approved by the “Consejo Interterritorial del Sistema Nacional de Salud” on 25 November 2020, to support the implementation of the strategy for neurodegenerative diseases (including ALS). This study was supported by the Department of Health (PERIS 2019 SLT008/18/00050 to GPR and SLT008/18/00061 to ALL) of the Generalitat of Catalonia.