Background: To describe trends in the incidence and outcomes for vascular dementia in elderly patients with and without type 2 diabetes (T2DM) in Spain between 2004 and 2013.
Methods: We used National Hospital Discharge Data to select all patients aged 70 years or over discharged from hospital with a vascular dementia primary diagnosis. Discharges were grouped by diabetes status (T2DM or non-diabetic). Incidence was calculated overall and stratified by diabetes status and age groups. We analyzed diagnostic and therapeutic procedures, patient comorbidities, infectious complications, length of hospital stay and in-hospital mortality (IHM).
Results: We identified a total of 170.607 admissions for vascular dementia (34.3% with T2DM). The adjusted incidence was higher among people with T2DM over the study period. We found a higher incidence in men than women in all years studied. T2DM was positively associated with vascular dementia hospitalization (IRR 2.14, 95% CI). Mean age at admission was higher than 80 years for all groups and more than 70% has a Charlson Comorbidity Index (CCI) ≥2. Pneumonia was significantly associated with a higher mortality (OR: 2.59; 95% CI 2.522.67). We found that percutaneous endoscopic gastrostomy (PEG) was associated to lower IHM (OR: 0.37, 95% CI 0.310.45) while parenteral nutrition had the opposite effect (OR: 1.29, 95% CI 1.181.41). Diabetes was not associated with a higher IHM (OR: 0.99, 95% CI 0.931.06). For the entire sample, time trend analyses showed a significant decrease in mortality in patients admitted for vascular dementia (OR: 0.98, 95% CI 0.970.99).
Conclusions: Incidence rates were higher in T2DM patients. Men have significant higher incidence rates than women. Pneumonia and parenteral nutrition were associated with mortality while PEG was associated to survival. The presence of diabetes is not associated with a higher IHM during admission with vascular dementia.
20 - 23 May 2017
European Society of Endocrinology