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

Abstract

Background 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.

Methods 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.

Results 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.

Conclusions 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.