Summary

Although it is not known exactly how many Australians have dementia, it is estimated to affect up to 436,000 people. In 2017, dementia caused more than 13,700 deaths and was the second-leading cause of death in Australia, behind coronary heart disease (18,600 deaths). Dementia is the leading cause of death for females.

Dementia is not 1 specific disease, but a term used to describe a group of conditions characterised by the gradual impairment of brain function. There are many different forms of dementia—Alzheimer’s disease is the most common. Although dementia can affect younger people, it occurs mainly among those aged over 65, and is a major cause of disability and dependency among older people.

This report focuses on hospital care provided for people with dementia in Australia in 2016–17; whether the number of hospitalisations has increased over the past decade; and the outcome of these hospitalisations.

What is the profile of dementia hospitalisations in Australia?

In 2016–17, there were about 94,800 hospitalisations of people who had at least 1 diagnosis of dementia. Of these hospitalisations:

  • 52% were of females, 48% were of males
  • 43% were of people aged 85–94, 3% were aged under 65
  • 1% were of Aboriginal and Torres Strait Islander Australians
  • 71% involved patients who lived in Major cities, 28% in Inner regional and Outer regional areas, and 1% in Remote and Very remote areas
  • 23% involved patients who lived in the lowest socioeconomic areas; 17% lived in the highest socioeconomic areas.

Who is most likely to be hospitalised with dementia?

In 2016–17:

  • male hospitalisation rates were 1.3 times as high as female rates
  • hospitalisation rates for people aged 95 and over were 5 times as high as those aged 75–79
  • Indigenous Australians’ hospitalisation rates were 1.5 times as high as for Other Australians
  • hospitalisation rates for people living in Major cities were 1.2 times as high as for people living in Inner regional and Outer regional areas
  • hospitalisation rates for people living in the lowest socioeconomic areas were 1.1 times as high as for people living in the highest socioeconomic areas.

About the dementia hospitalisations

  • About 9 in 10 (92%) involved at least 1 overnight stay; the average length of stay was 13 days.
  • 1 in 3 (33%) were for unspecified dementia, over 1 in 4 (27%) were for Alzheimer’s disease.
  • Almost 1 in 2 (48%) ended with the patient going home; about 1 in 3 (29%) ended with the  patient continuing care in hospital (for example, the patient was transferred to another hospital, or the type of hospital care changed); almost 1 in 5 (17%) ended in a new admission to residential aged care; and 6% ended with the patient dying in hospital.

8 health conditions were on average recorded in dementia hospitalisations

People with dementia may have more than 1 health condition. In 2016–17, dementia was recorded as the principal diagnosis in about 1 in 5 (22%) dementia hospitalisations and as an additional diagnosis in almost 4 in 5 (78%). On average, about 8 health conditions were recorded in dementia hospitalisations.

Type 2 diabetes was the most common comorbid condition, recorded in 24% of dementia hospitalisations. Where dementia was an additional diagnosis, the most common principal diagnosis was related to injury and poisoning (21%) and more than 1 in 3 (36%) of these were for a leg fracture.

7 in 10 dementia hospitalisations were of the highest clinical complexity

Almost all hospitalisations (97%) with at least 1 diagnosis of dementia were of the highest or second-highest clinical complexity. The majority (71%) were of the highest clinical complexity, compared with 16% of hospitalisations without a diagnosis of dementia.

Rate of dementia hospitalisations has decreased by almost a quarter in the last decade

Between 2006–07 and 2016–17, the age-adjusted rate of dementia hospitalisations decreased by 23%—from 408 to 313 hospitalisations per 100,000 population. Further, they:

  • decreased by 60% for unspecified dementia
  • remained similar for Alzheimer’s disease
  • increased by 37% for vascular dementia
  • increased by 416% for delirium superimposed on dementia.