Epidemiology of dementia: prevalence and incidence estimates using validated electronic health records from primary care

Figures & data

Figure 1 Definition of true and false cases of dementia.

Abbreviations: DSM, Diagnostic and Statistical Manual of Mental Disorders; ICD10, International Classification of Diseases, Tenth revision.

Figure 2 Incidence rate (A) and prevalence (B) of dementia.

Note: According to sex (green line, women; blue line, men; red line, overall population) by age-group in Catalan population aged at least 65 years.

Table 1 Crude and standardized incidence rates of dementia (per 1,000 person-years) in people aged ≥65 years in Catalonia (Spain) in 2016, stratified by sex and age

Groups	Cases	Person/years	Crude incidence (95% CI)	Standardized incidence (95% CI)
Whole population	9,596	1,008,755	9.5 (9.3–9.7)	8.6 (8.0–9.3)a
Sex
Women	6,218	567,836	11.0 (10.7–11.2)	9.4 (8.9–10.0)b
Men	3,378	440,919	7.7 (7.4–7.9)	7.8 (7.2–8.5)b
Age
65–69 years	330	282,876	1.2 (1.0–1.3)	1.2 (1.0–1.4)c
70–74 years	920	240,706	3.8 (3.6–4.1)	3.8 (3.5–4.2)c
75–79 years	1,574	173,703	9.1 (8.6–9.5)	9.0 (8.4–9.6)c
80–84 years	2,667	159,296	16.7 (16.1–17.4)	16.4 (15.5–17.3)c
85–89 years	2,490	97,631	25.5 (24.5–26.5)	24.9 (23.5–26.4)c
≥90 years	1,615	54,543	29.6 (28.2–31.1)	28.6 (26.5–30.8)c

a Note: Age-and sex-standardized;

b age-standardized;

c sex-standardized.

Table 2 Description of the characteristics of the primary care settings in Catalonia (Spain) in relation to dementia assessment

Dementia assessment	Study population (n=1,048,956), n (%)	Dementia-free patients (n=985,839), n (%)	Patients with dementia (n=63,117), n (%)
Patients at home-care program	67,441 (6.4)	50,944 (5.2)	16,497 (26.1)
Institutionalized patients	41,825 (4.0)	23,288 (2.4)	18,537 (29.4)
Cognitive abilities
Persons assessed	268,229 (25.6)	220,506 (22.4)	47,723 (75.6)
Persons impaired	76,410 (7.3)	40,787 (4.1)	35,623 (56.4)
Functional ability and independence
Persons assessed	242,251 (23.1)	201,203 (20.4)	41,048 (65.0)
Persons impaired	121,090 (11.5)	87,698 (8.9)	33,392 (52.9)

Table 3 Crude and adjusted prevalence of dementia in people aged ≥65 years in Catalonia (Spain) in 2016, stratified by sex and age

Groups	Cases	Population	Crude prevalence (95% CI)	Standardized prevalence (95% CI)
Whole population	63,117	1,048,956	6.0 (6.0–6.1)	5.1 (4.5–5.7)a
Sex
Women	43,995	599,942	7.3 (7.3–7.4)	5.9 (5.5–6.3)b
Men	19,122	449,014	4.3 (4.2–4.3)	4.2 (3.8–4.7)b
Age
65–69 years	2,151	282,815	0.8 (0.7–0.8)	0.8 (0.7-0.8)c
70–74 years	4,812	242,888	2.0 (1.9–2.0)	2.0 (1.9-2.1)c
75–79 years	8,750	179,329	4.9 (4.8–5.0)	4.8 (4.6-5.0)c
80–84 years	16,906	171,494	9.9 (9.7–10.0)	9.5 (9.2–9.8)c
85–89 years	17,884	110,530	16.2 (16.0–16.4)	15.4 (14.9–15.8)c
≥90 years	12,614	61,900	20.4 (20.1–20.7)	18.5 (17.8–19.2)c

a Note: Age-and sex-standardized;

b age-standardized;

c sex-standardized.

Figure S1 Summary of questionnaire for the validation of dementia diagnosis.

Abbreviations: CIE-10, Código Internacional de Enfermedades (Spanish version of the ICD); DSM, Diagnostic and Statistical Manual of Mental Disorders.

Table S1 Characteristics of study population to estimate incidence rate of dementia

Characteristics	Patients with dementia, n (%), x [SD]	Dementia-free patients, n (%), x [SD]	Study population, n (%), x [SD]
Age	82.9 [7.0]	75.6 [7.9]	75.7 [7.9]
Women	6,218 (64.8)	575,442 (56.1)	581,660 (56.2)
Coronary heart disease	1,150 (12.0)	100,134 (9.8)	101,284 (9.8)
Cerebrovascular disease	1,854 (19.3)	92,722 (9.0)	94,576 (9.1)
Hypertension	6,972 (72.7)	653,792 (63.8)	660,764 (63.8)
Hyperlipidemia	5,076 (52.9)	549,597 (53.6)	554,673 (53.6)
Depression	2,676 (27.9)	163,728 (16.0)	166,404 (16.1)
Diabetes	2,868 (29.9)	251,599 (24.5)	254,467 (24.6)
Anemia	2,392 (24.9)	155,196 (15.1)	157,588 (15.2)
Hyperthyroidism	57 (0.6)	5,072 (0.5)	5,129 (0.5)
Cancer	1,996 (20.8)	193,459 (18.9)	195,455 (18.9)

Table S2 Crude incidence rates of dementia (per 1,000 person-years) in people aged ≥65 years in Catalonia (Spain) in 2016, stratified by sex and age

Sex	Age group (years)	Cases	Person/years	Incidence (95% CI)
Women	65–69	174	149,440	1.2 (1.0–1.4)
	70–74	522	129,528	4.0 (3.7–4.4)
	75–79	929	95,991	9.7 (9.1–10.3)
	80–84	1,739	93,356	18.6 (17.8–19.5)
	85–89	1,667	61,408	27.2 (25.9–28.5)
	≥90	1,187	38,113	31.1 (29.4–33.0)
Men	65–69	156	133,436	1.2 (1.0–1.4)
	70–74	398	111,178	3.6 (3.2–4.0)
	75–79	645	77,711	8.3 (7.7–9.0)
	80–84	928	65,940	14.1 (13.2–15.0)
	85–89	823	36,223	22.7 (21.2–24.3)
	≥90	428	16,430	26.1 (23.6–28.6)

Table S3 Characteristics of study population to estimate dementia prevalence that includes persons aged ≥65 years registered in SIDIAP on December 31, 2016

Characteristics	Patients with dementia, n (%), x [SD]	Dementia-free patients, n (%), x [SD]	Study population, n (%), x [SD]
Age	83.7 [6.9]	75.4 [7.7]	75.9 [7.9]
Women	43,995 (69.7)	555,947 (56.4)	599,942 (57.2)
Coronary heart disease	7,122 (11.3)	93,749 (9.5)	100,871 (9.6)
Cerebrovascular disease	12,281 (19.5)	85,878 (8.7)	98,159 (9.4)
Hypertension	44,880 (71.1)	628,783 (63.8)	673,663 (64.2)
Hyperlipidemia	34,324 (54.4)	533,427 (54.1)	567,751 (54.1)
Depression	18,389 (29.1)	157,376 (15.9)	175,765 (16.8)
Diabetes	18,361 (29.1)	239,853 (24.3)	258,214 (24.6)
Anemia	17,125 (27.1)	143,399 (14.6)	160,524 (15.3)
Hyperthyroidism	412 (0.7)	4,868 (0.5)	5,280 (0.5)
Cancer	11,914 (18.9)	179,050 (18.2)	190,964 (18.2)

Abbreviation: SIDIAP, System for the Development of Research in Primary Care.

Table S4 Crude prevalence of dementia in people aged ≥65 years in Catalonia (Spain) in 2016, stratified by sex and age

Sex	Age-group (years)	Cases	Population	Prevalence (95% CI)
Women	65–69	1,180	149,811	0.8 (0.7–0.8)
	70–74	2,767	131,252	2.1 (2.0–2.2)
	75–79	5,446	100,054	5.4 (5.3–5.6)
	80–84	11,493	102,434	11.2 (11.0–11.4)
	85–89	12,923	71,533	18.1 (17.8–18.3)
	≥90	10,186	44,858	22.7 (22.3–23.1)
Men	65–69	971	133,004	0.7 (0.7–0.8)
	70–74	2,045	111,636	1.8 (1.8–1.9)
	75–79	3,304	79,275	4.2 (4.0–4.3)
	80–84	5,413	69,060	7.8 (7.6–8.0)
	85–89	4,961	38,997	12.7 (12.4–13.1)
	≥90	2,428	17,042	14.2 (13.7–14.8)