Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers

Abstract

Background: Facing an increasing prevalence of dementia, the Czech Republic is developing a new nationwide strategy for the management and prevention of dementia. Lack of evidence about characteristics of individuals with dementia in the country is a major obstacle. Objective: The study aimed to 1) characterize individuals with dementia, 2) compare their mortality with the general population, and 3) analyze differences in survival between different dementia disorders. Methods: The study capitalizes on two nationwide registers in the Czech Republic, from which information about individuals who were hospitalized with dementia or died from it between 1994 and 2014 was retrieved. Standardized intensity of hospitalizations was calculated for each year, mortality was studied using standardized mortality ratio, life-tables, Kaplan-Mayer curves, and Cox proportional hazard models. Results: Standardized intensity of hospitalizations for dementia increased more than 3 times from 1994 to 2014. Standardized mortality ratio was 3.03 (95% confidence interval 2.97-3.08). One-year survival rate was 45% and five-year survival rate 16%. Vascular dementia was the most common type of dementia disorders and was associated with higher hazard of death than Alzheimer's disease, even after adjusting for sociodemographic and clinical covariates (hazard ratio 1.04; 95% confidence interval 1.02-1.05). Conclusion: The study provides estimates on demographic characteristics and mortality of the Czech hospitalized dementia population, which have not been so far available and which are unique also in the context of the entire region of Central and Eastern Europe.

Dementia epidemiology in Hungary based on data from neurological and psychiatric specialty services

“…The shortest survival seen in VaD might be explained by the higher risk of stroke and other cardiovascular diseases, the late complications of cerebral infarctions and by the finding that demented patients receive poorer quality of care with worse outcomes after stroke 31 . These observations are supported by the findings of Broulikova et al 32 from Czech registers on hospitalized dementia patients.…”

Injurious falls before, during and after dementia diagnosis: a population-based study

“…Third, the progression of white matter changes [ 50 ] and subcortical infarcts [ 51 ] may disrupt the integrity of neural networks including long-descending motor fibres and frontal–subcortical circuits that control motor and cognitive function, leading to falls [ 52 ]. Finally, the decrease in fall incidence after dementia diagnosis might be partially driven by an increase in hospitalization and death among people with dementia [ 53 , 54 ]. Moreover, people diagnosed with dementia often receive a variety of health care and home care services, such as personal care, house cleaning, laundry and accompanying walks, which may be beneficial in reducing the incidence of falls [ 55 , 56 ].…”

A study of the relationship between vestibular loss and the risk of dementia using data from the south korea national insurance service survey from 2002 to 2019

“…Recently, several nationwide studies have documented their databases on dementia registration. [19][20][21] Although each study is slightly different in the ICD-10 codes for dementia and features for de ning dementia, such as medications to treat dementia, underlying or contributing causes of death, and hospital admissions, our de nition is similar to previous studies. [19][20][21][22][23] Our results demonstrated that vestibular loss increased the risk of dementia and these results were correlated with the previous studies.…”