Insights into young-onset dementia hospitalizations: An 8-year nationwide study using administrative data

• Published in: Archives of gerontology and geriatrics 2025-02, Vol.129, p.105666, Article 105666
• Main Authors: Pinto, Bárbara Ferraz, Gonçalves-Pinho, Manuel, Freitas, Alberto, Fernandes, Lia, Ferreira, Ana Rita
• Format: Article
• Language: English
• Subjects: Adult; Age of Onset; Alzheimer's disease; Comorbidity; Databases, Factual; Dementia; Dementia - epidemiology; Early-onset dementia; Female; Hospital administrative data; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Portugal - epidemiology; Retrospective Studies; Young-onset dementia
• ISSN: 0167-4943; 1872-6976; 1872-6976
• DOI: 10.1016/j.archger.2024.105666

•Young-onset dementia hospitalizations often have preventable or curable underlying causes.•Vascular dementia was the most prevalent cause of dementia among young-onset dementia hospitalizations.•Alcohol-related dementia ranked fourth in young-onset dementia hospitalizations.•Younger individuals have lengthier hospitalizations than their older counterparts. To characterize all Portuguese public hospitalizations of patients aged < 65 years with a primary or secondary diagnosis of dementia, based on ICD-9-CM coding. A retrospective observational study was conducted using a nationwide database encompassing all hospitalizations occurred in Portuguese mainland public hospitals with discharge from 2008 to 2015. Hospitalizations of patients aged 35–64 years with primary or secondary diagnoses of dementia were selected based on ICD-9-CM codes 290.1X-290.4X, 291.2, 292.82, 294.1X, 294.2X, 331.0, 331.1X, 331.82, 333.4 and 046.1, excluding diagnostic codes 317-319, 330.X, 343, 758.0-758.3 and 759.3. Information on age, sex, primary diagnosis, comorbidities (secondary diagnosis), type of admission, length of stay (LoS), in-hospital mortality, suicide attempts, discharge destination, readmissions and dementia etiology was collected. From 7971 hospitalizations, for 5682 inpatients, the median age was 57.3 years (SD±6.5) and 61.8% were of male patients. Vascular dementia was the most prevalent etiology, followed by Alzheimer's disease. Most admissions were urgent and had a primary diagnosis of ‘Delirium, dementia and other cognitive disorders’, followed by pneumonia and alcohol-related disorders. Dementia, cerebrovascular disease and diabetes were the most common comorbidities. Overall, 55.4% of admissions were first-time admissions during the study period and the median LoS was 10.0 days (Q1;Q3: 5.0;20.0). Suicide attempts were recorded in 0.6% of the episodes. The in-hospital mortality rate was 9.2% and most patients were discharged home (80.2%). This study describes the complexity and strain of young-onset dementia hospitalizations providing a detailed overview and recommendations for further research and tailored interventions.