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. 2025 Nov 12;25(1):3919.
doi: 10.1186/s12889-025-24341-4.

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

Eva M Melendo-Azuela #  1   2   3   4 , Albert Lladó #  5 , Emili Vela  6   7 , Sonia Mariscal  1 , Montserrat Cleries  6   7 , Gerard Piñol-Ripoll  8 , Sebastià J Santaeugènia  1   2   4
Affiliations

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

Eva M Melendo-Azuela et al. BMC Public Health. .

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.

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

Keywords: Cognitive impairment; Dementia; Dementia expenditures; Epidemiology; Healthcare services utilization; Incidence; Mortality; Prevalence.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The ethics principles of the Helsinki Declaration, the local Personal Data Protection Law (LOPD 3/2018) and the General Data Protection Regulation (EU) were observed, and the Research Ethics Committee of the University of Vic/Central University of Catalonia (UVIC-UCC) approved the study (reference number 183/2021). Consent for publication: No individual person’s data in any form are included in this article. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Evolution of prevalence (A) and incidence (B) rates of dementia in Catalonia according to type of diagnosis (2013–2020) A)
Fig. 2
Fig. 2
Evolution of mean age of incident cases of dementia in Catalonia according to sex (A) and type of diagnosis (B) (2013–2020)
Fig. 3
Fig. 3
Evolution of annual mortality rate (1 per 100 inhabitants) of dementia in Catalonia according to type of diagnosis (2013–2020)
See this image and copyright information in PMC

References

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