{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T21:02:49Z","timestamp":1773867769825,"version":"3.50.1"},"reference-count":33,"publisher":"BMJ","issue":"8","funder":[{"name":"Grupo de Excelencia Investigadora URJC-Banco Santander. Investigaci\u00f3n traslacional en el proceso de salud\u2014enfermedad (ITPSE)."},{"name":"Fondo de Investigaciones Sanitarias\u2014Health Research Fund, Instituto de Salud Carlos III) co-financed by the European Union through the Fondo Europeo de Desarrollo Regional"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,5,5]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine trends overtime in the incidence and in-hospital outcomes of vascular dementia (VaD) hospitalisations in patients aged 70 years or over suffering and not suffering from type 2 diabetes mellitus (T2DM) between 2004 and 2013 in Spain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Spain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>National hospital discharge data were used; patients aged \u226570,\u2009discharged from a hospital with VaD as a primary diagnosis, were selected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Overall incidence, therapeutic and diagnostic procedures, comorbidities, infectious complications, duration of hospital stays and in-hospital mortality (IHM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 170\u2009607 admissions for VaD (34.3% with T2DM) were identified. We found a significant upward linear trend in the incidence of VaD for men and women with and without diabetes between 2004 and 2013. 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 under study. A positive association between T2DM and VaD hospitalisation was found among both men (IRR 2.14, 95%\u2009CI 2.11 to 2.16) and women (incidence rate ratio (IRR) 2.22; 95%\u2009CI 2.19 to 2.25). Pneumonia was significantly associated with a higher mortality (OR 2.59, 95%\u2009CI 2.52 to 2.67). We found that percutaneous endoscopic gastrostomy was associated with lower IHM (OR 0.37, 95%\u2009CI 0.31 to 0.45), while parenteral nutrition had the opposite effect (OR 1.29, 95%\u2009CI 1.18 to 1.41). There was no association between diabetes and higher IHM (OR 0.99, 95%\u2009CI 0.93 to 1.06). The time-trend analyses of the entire sample showed a significant reduction in mortality in patients with VaD (OR 0.98, 95%\u2009CI 0.97 to 0.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Incidence rates for VaD hospitalisations were twice as high in patients with diabetes compared with those without. Men had significantly higher incidence rates than women, regardless of diabetes status. In both groups studied, pneumonia and parenteral nutrition were associated with mortality while percutaneous endoscopic gastrostomy was associated with survival. Having diabetes was not associated with higher IHM after hospitalisation with VaD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016390","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T12:02:07Z","timestamp":1544529727000},"page":"e016390","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Observational study of vascular dementia in the Spanish elderly population according to type 2 diabetes status: trends in incidence, characteristics and outcomes (2004-2013)"],"prefix":"10.1136","volume":"7","author":[{"given":"Nuria","family":"Mu\u00f1oz-Rivas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Infanta Leonor, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"M\u00e9ndez-Bail\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 M de","family":"Miguel-Yanes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valent\u00edn","family":"Hern\u00e1ndez-Barrera","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier de","family":"Miguel-D\u00edez","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Jimenez-Garcia","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"L\u00f3pez-de-Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,8,4]]},"reference":[{"key":"2025121601253524000_7.8.e016390.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2012.11.007"},{"key":"2025121601253524000_7.8.e016390.2","unstructured":"World Health Organization. Dementia. http:\/\/www.who.int\/mediacentre\/factsheets\/fs362\/en\/ (Accessed February 10, 2017)."},{"key":"2025121601253524000_7.8.e016390.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30029-1"},{"key":"2025121601253524000_7.8.e016390.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.110361"},{"key":"2025121601253524000_7.8.e016390.5","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-005-0069-1"},{"key":"2025121601253524000_7.8.e016390.6","unstructured":"World Health Organization. Global Report on Diabetes. http:\/\/apps.who.int\/iris\/bitstream\/10665\/204871\/1\/9789241565257_eng.pdf (Accessed February 10, 2017)."},{"key":"2025121601253524000_7.8.e016390.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fendo.2014.00143","article-title":"Brain alterations and clinical symptoms of dementia in diabetes: a\u03b2\/tau-dependent and independent mechanisms","volume":"5","author":"Sato","year":"2014","journal-title":"Front Endocrinol"},{"key":"2025121601253524000_7.8.e016390.8","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.diabet.2014.02.002","article-title":"Update on cognitive decline and dementia in elderly patients with diabetes","volume":"40","author":"Bordier","year":"2014","journal-title":"Diabetes Metab"},{"key":"2025121601253524000_7.8.e016390.9","doi-asserted-by":"crossref","first-page":"393","DOI":"10.3233\/JAD-160114","article-title":"An Update on type 2 Diabetes Mellitus as a risk factor for Dementia","volume":"53","author":"Li","year":"2016","journal-title":"J Alzheimers Dis"},{"key":"2025121601253524000_7.8.e016390.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0004144","article-title":"Diabetes and the risk of multi-system aging phenotypes: a systematic review and meta-analysis","volume":"4","author":"Lu","year":"2009","journal-title":"PLoS One"},{"key":"2025121601253524000_7.8.e016390.11","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-1588"},{"key":"2025121601253524000_7.8.e016390.12","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afs188"},{"key":"2025121601253524000_7.8.e016390.13","unstructured":"Instituto Nacional de Gesti\u00f3n Sanitaria, Ministerio de Sanidad, Servicios Sociales e Igualdad. Conjunto M\u00ednimo B\u00e1sico de Datos, Hospitales del INSALUD http:\/\/www.ingesa.msc.es\/estadEstudios\/documPublica\/CMBD-2001.htm (Accessed February 10, 2017)."},{"key":"2025121601253524000_7.8.e016390.14","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"2025121601253524000_7.8.e016390.15","first-page":"719","article-title":"Epidemiology of diabetes and risk of dementia","volume":"68","author":"Ohara","year":"2016","journal-title":"Brain Nerve"},{"key":"2025121601253524000_7.8.e016390.16","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-014-0487-z"},{"key":"2025121601253524000_7.8.e016390.17","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f4d7f8"},{"key":"2025121601253524000_7.8.e016390.18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0145535","article-title":"Time Trends in ischemic stroke among type 2 Diabetic and Non-Diabetic patients: analysis of the Spanish National Hospital Discharge Data (2003-2012)","volume":"10","author":"Mu\u00f1oz-Rivas","year":"2015","journal-title":"PLoS One"},{"key":"2025121601253524000_7.8.e016390.19","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1155\/2010\/742523","article-title":"Does diabetes mellitus alter the onset and clinical course of vascular dementia?","volume":"23","author":"Murthy","year":"2010","journal-title":"Behav Neurol"},{"key":"2025121601253524000_7.8.e016390.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2010.08.048"},{"key":"2025121601253524000_7.8.e016390.21","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.jdiacomp.2015.06.010","article-title":"Association between comorbidities and dementia in diabetes mellitus patients: population-based retrospective cohort study","volume":"29","author":"Kuo","year":"2015","journal-title":"J Diabetes Complications"},{"key":"2025121601253524000_7.8.e016390.22","doi-asserted-by":"crossref","unstructured":"Chang CC , Lin PH , Chang YT , et al . The impact of admission diagnosis on recurrent or frequent hospitalizations in 3 dementia subtypes: a hospital-based cohort in Taiwan with 4 years longitudinal follow-ups. Medicine (Baltimore) 2015;94:e 2091.","DOI":"10.1097\/MD.0000000000002091"},{"key":"2025121601253524000_7.8.e016390.23","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1097\/CCM.0000000000000123","article-title":"Infection hospitalization increases risk of Dementia in the Elderly*","volume":"42","author":"Tate","year":"2014","journal-title":"Crit Care Med"},{"key":"2025121601253524000_7.8.e016390.24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.14.1365"},{"key":"2025121601253524000_7.8.e016390.25","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2000.00565.x"},{"key":"2025121601253524000_7.8.e016390.26","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.02.031","article-title":"Type 2 Diabetes and hemorrhagic stroke: a Population-Based study in Spain from 2003 to 2012","volume":"25","author":"Mu\u00f1oz-Rivas","year":"2016","journal-title":"Journal of Stroke and Cerebrovascular Diseases"},{"key":"2025121601253524000_7.8.e016390.27","doi-asserted-by":"publisher","DOI":"10.2337\/dcS13-2023"},{"key":"2025121601253524000_7.8.e016390.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.11.039"},{"key":"2025121601253524000_7.8.e016390.29","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01802-2"},{"key":"2025121601253524000_7.8.e016390.30","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1475-2840-13-3","article-title":"National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001-2011)","volume":"13","author":"Lopez-de-Andres","year":"2014","journal-title":"Cardiovasc Diabetol"},{"key":"2025121601253524000_7.8.e016390.31","first-page":"69","article-title":"The validity of national hospital discharge register data on dementia: a comparative analysis using clinical data from a university medical centre","volume":"73","author":"van de Vorst","year":"2015","journal-title":"Neth J Med"},{"key":"2025121601253524000_7.8.e016390.32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0075256","article-title":"Systematic review and Meta-Analysis of Validation studies on a Diabetes Case Definition from Health Administrative Records","volume":"8","author":"Leong","year":"2013","journal-title":"PLoS One"},{"key":"2025121601253524000_7.8.e016390.33","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000174293.17959.a1"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-016390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:25:48Z","timestamp":1765877148000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-016390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,8,4]]},"published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1136\/bmjopen-2017-016390"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-016390","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}