Prevalence of Dementia among Patients Hospitalized with Type 2 Diabetes Mellitus in Spain, 2011–2020: Sex-Related Disparities and Impact of the COVID-19 Pandemic

Ana Lopez- de-Andres (), Rodrigo Jimenez-Garcia, Jose J. Zamorano-Leon, Ricardo Omaña-Palanco, David Carabantes-Alarcon, Valentin Hernández-Barrera, Javier De Miguel-Diez and Natividad Cuadrado-Corrales
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Ana Lopez- de-Andres: Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Rodrigo Jimenez-Garcia: Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Jose J. Zamorano-Leon: Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Ricardo Omaña-Palanco: Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
David Carabantes-Alarcon: Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Valentin Hernández-Barrera: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
Javier De Miguel-Diez: Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain
Natividad Cuadrado-Corrales: Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain

IJERPH, 2023, vol. 20, issue 6, 1-14

Abstract: (1) Background: To assess changes in the prevalence of dementia among patients hospitalized with type 2 diabetes (T2DM), to analyze the effects of dementia on in-hospital mortality (IHM) in this population, to evaluate sex differences, and to determine the impact of the COVID-19 pandemic on these parameters. (2) Methods: We used a nationwide discharge database to select all patients with T2DM aged 60 years or over admitted to Spanish hospitals from 2011 to 2020. We identified those with all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VaD). The effect of sex, age, comorbidity, and COVID-19 on the prevalence of dementia subtypes and on IHM was assessed using multivariable logistic regression. (3) Results: We identified 5,250,810 hospitalizations with T2DM. All-cause dementia was detected in 8.31%, AD in 3.00%, and VaD in 1.55%. The prevalence of all subtypes of dementia increased significantly over time. After multivariable adjustment, higher values were observed in women for all-cause dementia (OR 1.34; 95% CI 1.33–1.35), AD (OR 1.6; 95% CI 1.58–1.62), and VaD (OR 1.12; 95% CI 1.11–1.14). However, female sex was a protective factor for IHM in patients with all-cause dementia (OR 0.90; 95% CI 0.89–0.91), AD (OR 0.89; 95% CI 0.86–0.91), and VaD (OR 0.95; 95% CI 0.91–0.99). IHM among patients with dementia remained stable over time, until 2020, when it increased significantly. Higher age, greater comorbidity, and COVID-19 were associated with IHM in all dementia subtypes. (4) Conclusions: The prevalence of dementia (all-cause, AD, and VaD) in men and women with T2DM increased over time; however, the IHM remained stable until 2020, when it increased significantly, probably because of the COVID-19 pandemic. The prevalence of dementia is higher in women than in men, although female sex is a protective factor for IHM.

Keywords: type 2 diabetes; dementia; Alzheimer’s disease; vascular disease; COVID-19; in-hospital mortality; hospitalization; sex (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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