Background and Purpose
Dementia is rapidly becoming more common in the elderly population of South Korea, and there are regional difference in its demographics. This study investigated the trajectories in the prevalence and incidence of dementia based on the Seoul metropolitan area and other areas in South Korea using big data from the National Health Insurance Service (NHIS).
Methods
We examined a population-based elderly cohort obtained from the NHIS Senior Cohort (NHIS-SC) data set that comprises approximately half a million recipients of medical insurance in South Korea during 2003–2015. The age-standardized prevalence and incidence of dementia as well as their trajectories from 2003 were estimated. Regional differences in these rates between Seoul metropolitan area and other areas were also analyzed.
Results
The standardized prevalence of dementia per 100,000 increased significantly from 178.11 in 2003 to 5,319.01 in 2015 (
p
<0.001). The standardized prevalence of dementia was higher in other areas than in Seoul metropolitan area. The standardized incidence of dementia per 100,000 person-years also increased significantly, from 126.41 in 2003 to 2,218.25 in 2015 (
p
<0.001). The standardized incidence of dementia was similarly higher in other areas than in Seoul metropolitan area (
p
<0.001).
Conclusions
This study has shown that the standardized prevalence and incidence of dementia increased steadily from 2003 to 2015 in South Korea based on the NHIS-SC data set, and differed between Seoul metropolitan area and other areas.
Background and Purpose
Dementia has been reported to be associated with an increased risk of hip fracture, but few case-control studies have been performed to actually confirm this. This study investigated the association between dementia and hip fracture by comparing the risk of hip fracture between subjects with and without dementia.
Methods
We examined a population-based matched cohort from the National Health Insurance Service-Senior Cohort data set that covers approximately half a million recipients of medical insurance in South Korea. Subjects with new clinically verified dementia during 2003–2007 were included, and five subjects without dementia were matched for age, sex, and index year to each subject with dementia as the controls. The risk of hip fracture for dementia was evaluated up to 2015 using Cox regression analysis.
Results
During the 12-year follow-up period, 284 subjects with dementia (10.66%) and 603 subjects without dementia (4.53%) experienced hip fractures. Dementia was independently associated with a higher risk of hip fracture [hazard ratio (HR)=2.840, 95% CI=2.449–3.293] and the adjusted HR for hip fracture in the subjects with dementia was highest within 2 years after the initial diagnosis (HR=2.862, 95% CI=2.053–3.990).
Conclusions
This study found that dementia could be an independent risk factor for hip fracture even at the early stage. This necessitates consideration of the future risk of falls and balance deficits in terms of physical activity after a diagnosis of dementia.
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