Hospitalisations due to dementia

In 2023–24, there were just over 12.6 million hospitalisations in Australia. Of these, about 27,800 were hospitalisations due to dementia (Table S9.1), which is equivalent to 1 out of every 455 hospitalisations in Australia (Table S9.4). 

Table 9.1 shows that of the hospitalisations due to dementia in 2023–24:

  • there were more hospitalisations for men than women (14,100 hospitalisations compared to 13,700 hospitalisations)
  • men had a higher rate of hospitalisations than women (49 hospitalisations for men and 42 hospitalisations for women, per 10,000 population aged 60 and over; Table S9.2)
  • the average length of stay was 15 days – this was almost 6 times higher than the average length of stay of 2.7 days for all hospitalisations (AIHW 2024)
  • the average length of stay was longer for men (16 days) than women (14 days).
Table 9.1: Overview of hospitalisations due to dementia by sex, in 2023–24

Measure

Men

Women

Persons

Number of hospitalisations

14,100

13,700

27,800

Rate of hospitalisations (number per 10,000 population aged 60 and over)

49

42

45

Average length of stay, days per hospitalisation

16

14

15

Total number of bed days

225,000

195,000

420,000

Note: Numbers may not add up due to rounding, exact numbers can be found in Table S9.1 and Table S9.2.

Source: AIHW analysis of National Hospital Morbidity Database.

Age and sex trends in hospitalisations due to dementia

There were distinct patterns in hospitalisations due to dementia in 2022–23 by age and sex (Figure 9.1):

    • The number of hospitalisations increased with age up to 80–84 years for men and 85–89 for women.
    • The rate of hospitalisations for both men and women increased with age up to 90–94 years.
    • Average length of stay was highest for people with younger onset dementia (aged under 65, 23 days) and decreased with age, to 11 days for aged 95 and over. This trend was observed among both men and women.
    • For both men and women, the total number of bed days was highest for people aged 75 to 89.

Figure 9.1: Overview of hospitalisations due to dementia, by age and sex, in 2023–24

This figure shows various measures of hospitalisations due to dementia in Australia by age and sex in 2023–24, including: the estimated number of hospitalisations due to dementia, rate of hospitalisations (per 10,000 population), bed days and average length of stay (days). Distinct patterns are explained in the previous paragraphs.  

This figure shows various measures of hospitalisations due to dementia in Australia by age and sex in 2023–24, including: the estimated number of hospitalisations due to dementia, rate of hospitalisations (per 10,000 population), bed days and average length of stay (days). Distinct patterns are explained in the previous paragraphs.  

Trends in hospitalisations due to dementia 

All rates have been age-standardised to adjust for population differences, providing a more accurate reflection of changes over time. 

Figure 9.2 shows the number and age-standardised rate of hospitalisations due to dementia between 2014–15 and 2023–24:

  • Between 2016–17 and 2023–24, the number of hospitalisations due to dementia increased by 31%, while the age-standardised rate of hospitalisations remained relatively steady.
  • Between 2014–15 and 2015–16 there was a large increase in both the number of hospitalisations (24% increase) and the age-standardised rate (23% increase). This increase is likely due to changes in coding for rehabilitation which came into effect in 2015–16 (for more information see Box 9.2).
  • Although the numbers of hospitalisations for men and women were similar throughout the period, men consistently had higher rates of hospitalisations than women. 

Figure 9.2: Hospitalisations due to dementia: number and age-standardised rates between 2014–15 and 2023–24

Two-line graphs showing the estimated number and age-standardised rates of hospitalisations due to dementia in Australia by sex between 2014–15 and 2023–24. Distinct patterns are explained in the previous paragraphs.

Two-line graphs showing the estimated number and age-standardised rates of hospitalisations due to dementia in Australia by sex between 2014–15 and 2023–24. Distinct patterns are explained in the previous paragraphs.

Notes:

  1. The age-standardised rates, which apply to people aged 60 and over, were standardised to the Australian population as at 30 June 2001 and are expressed per 10,000 population.
  2. Hospitalisations due to dementia only include hospitalisations when dementia was recorded as the principal diagnosis.

Box 9.2: Coding changes impacting hospitalisations due to dementia over time

With many national health data collections, the primary purpose is to support the administrative objectives of the collecting organisation rather than to monitor disease. Factors such as changes in coding practices may affect how well conditions are recorded in the data. 

The period 2014–15 to 2015–16 saw a substantial increase in hospitalisations due to dementia (where dementia was the principal diagnosis). In July 2015, a new coding standard ACS2104 Rehabilitation was introduced into the ICD-10-AM. Changes that may have led to an increase in admissions with dementia coded as the principal diagnosis include:

prior to July 2015, patients who were admitted to hospital specifically for rehabilitation were assigned a principal diagnosis of Z50.9 Care involving use of rehabilitation procedure, unspecified, and the condition which led to the need for rehabilitation (such as dementia) was assigned as an additional diagnosis

in July 2015, this coding standard was revised so that the principal diagnosis should be assigned to the condition which led to the need for rehabilitation, and Z50.9 Care involving use of rehabilitation procedure, unspecified should be assigned as an additional diagnosis. 

When changes such as these are implemented in short time periods, distinct steps up or down in numbers and rates are expected to be observed in administrative data.

Types of dementia recorded in hospitalisations due to dementia 

In 2023–24, the most common dementia types recorded in hospitalisations due to dementia were: 

  • Alzheimer’s disease (32%) 
  • other dementia (18%) 
  • unspecified dementia (17%)
  • vascular dementia (13%) (Figure 9.3).

Although not a distinct type of dementia, Delirium superimposed on dementia occurs when a person with pre-existing dementia experiences delirium, and is a common cause of hospitalisations among people with dementia. In 2023–24, 11% of hospitalisations due to dementia were for Delirium superimposed on dementia (Table S9.3). 

Since the Dementia in Australia 2024 update, Mixed dementia, has been included in Table S9.3. Mixed dementia is defined by AIHW as an admitted patient episode with a principal diagnosis of one dementia type plus an additional diagnosis of another dementia type. This method does not use linked data so a person may have different dementia types recorded in different episodes, but it is not possible to compare across episodes. 

There were just under 2,400 hospitalisations due to Mixed dementia in 2023–24 (8.5% of all hospitalisations due to dementia). The most common form of Mixed dementia is Alzheimer’s disease and vascular dementia (Dementia Australia, 2023). 

For more information on rarer dementia types, see Less common dementias.  

Figure 9.3: Hospitalisations due to dementia: percentage, by type of dementia and sex in 2023–24

A bar graph showing the percentage of hospitalisations due to dementia in Australia by type of dementia and sex in 2023–24. The most common dementia type recorded was Alzheimer’s disease. Distinct patterns are explained in the previous paragraphs.

A bar graph showing the percentage of hospitalisations due to dementia in Australia by type of dementia and sex in 2023–24. The most common dementia type recorded was Alzheimer’s disease. Distinct patterns are explained in the previous paragraphs.

Notes

  1. 'Other dementia' consists of cases of dementia that do not meet the definition for other dementia types listed, including dementia in other specified diseases classified elsewhere (F02.8) where Lewy Body disease is not present, unspecified dementia (F03) where another dementia is listed as an additional diagnosis, and delirium superimposed on dementia (F05.1) where another dementia is listed as an additional diagnosis. 
  2. 'Other degenerative diseases of nervous system (not elsewhere classified)' was considered a hospitalisation due to dementia only when dementia was recorded as an additional diagnosis. 
  3. 'Delirium superimposed on dementia' was included in the total number of hospitalisations due to dementia, but is not shown in this figure as it is not a distinct type of dementia.
  4. 'Mixed dementia' is defined as an admitted patient episode with a principal diagnosis of one dementia type plus an additional diagnosis of another dementia type.

How did hospitalisations due to dementia end?

In 2023–24, of the hospitalisations due to dementia:

  • 37% ended in the patient being discharged home (Table S9.4). This proportion was considerably less than that for all hospitalisations in 2023–24, where 92% ended in the patient being discharged home
  • 9.7% were discharged to their usual place of residence in a residential aged care home
  • 9.4% were transferred to a residential aged care home which was not their usual place of residence: of these, 2 in 3 patients were aged over 80 (Table S9.5)
  • 5.1% ended with the death of the patient. 

About a quarter (29%) of hospitalisations due to dementia ended with a ‘Statistical discharge’, which is when the intent of care changed during their stay in hospital (for example, from acute care to rehabilitation or palliative care). A further 8.2% of hospitalisations due to dementia ended with discharge or transfer to another acute hospital.

When Australians were hospitalised due to dementia, what other conditions did they have?

When Australians were admitted to hospital due to dementia, the most common other diagnoses (additional diagnosis and supplementary diagnosis) were:

  • hypertension
  • type 2 diabetes mellitus
  • other functional intestinal disorders
  • arthritis and osteoarthritis primary
  • problems related to care-provider dependency
  • ischaemic heart disease (also known as coronary heart disease)
  • depression.

A number of these diagnoses, such as hypertension, diabetes and depression, are modifiable risk factors for dementia. 

Hospitalisations due to dementia involving palliative and other end-of-life care

In 2023–24, there were 1,700 palliative care-related hospitalisations due to dementia, accounting for 6.1% of all hospitalisations due to dementia (4.1% for palliative care and 2% for other end-of-life care; Table S9.7). Palliative care-related hospitalisations include hospitalisations with a care type of palliative care, in which specialist palliative care is provided, as well as hospitalisations where a palliative care diagnosis was recorded, but care was not necessarily delivered by a palliative care specialist (referred to as other end-of-life care). For more detail, see Palliative care services in Australia.

The rate of palliative care-related hospitalisations was similar for men and women. For both men and women, the rate of palliative care-related hospitalisations was between 4 and 6% for people aged under 85, 9% for people aged 90 to 94, and 15% for people aged 95 or over.

How do hospitalisations due to dementia vary by geographic and socioeconomic areas?

Table S9.8 shows the crude and age-standardised rates of hospitalisations due to dementia by state and territory, remoteness areas and socioeconomic areas for 2023–24. 

In 2023–24, the rate of hospitalisations due to dementia for people aged 60 and over:

  • varied across states and territories – ranging from 34 hospitalisations per 10,000 population in Tasmania to 68 hospitalisations per 10,000 population in South Australia
  • varied by remoteness – highest in Major cities (48 hospitalisations per 10,000 population) and lowest in Very remote areas (26 hospitalisations per 10,000 population)
  • was lowest among people living in the highest socioeconomic areas (41 per 10,000 population) and highest among people living in the lowest socioeconomic areas (49 per 10,000 population). 

Socioeconomic and demographic factors such as income, education, employment, geographic access to health and social support services, as well as identifying as a First Nations or culturally and linguistically diverse (CALD) person, may impact hospitalisations of people with dementia. For more information refer to Hospital care for First Nations people with dementia and Health services used by people with younger onset dementia.