{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:10:39Z","timestamp":1790273439045,"version":"4.1.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002911","name":"Universidad Complutense de Madrid","doi-asserted-by":"publisher","award":["970970"],"award-info":[{"award-number":["970970"]}],"id":[{"id":"10.13039\/501100002911","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002911","name":"Universidad Complutense de Madrid","doi-asserted-by":"publisher","award":["970793"],"award-info":[{"award-number":["970793"]}],"id":[{"id":"10.13039\/501100002911","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The co-occurrence of type 2 diabetes mellitus (T2DM) and dementia represents a major public health challenge in Spain, where prevalence among hospitalized patients rose from 6.9% in 2011 to 10.6% in 2020. However, post-pandemic trends and sex-specific clinical outcomes remain under-characterized. We aimed to evaluate the frequency and temporal trends of dementia subtypes, clinical profiles, and predictors of in-hospital mortality (IHM) among T2DM-related hospitalizations in Spain (2021\u20132024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide retrospective observational study using the Spanish National Hospital Discharge Database (RAE-CMBD) and analyzed 2,786,184 T2DM-related hospital discharge episodes recorded between 2021 and 2024. The unit of analysis was the hospitalization episode rather than the unique individual; therefore, recurrent admissions for the same person could be included as separate observations. Multivariable logistic regression identified independent predictors of dementia presence and IHM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All-cause dementia was coded in 180,623 hospital episodes, corresponding to 6.48% of T2DM-related hospitalizations. This proportion was higher among hospitalizations involving women than among those involving men. Regarding specific subtypes, AD was the most frequent diagnosis with 80,174 cases (2.88% prevalence), presenting an IHM of 16.3% across the study period. VaD affected 1.44% of the sample. A remarkably strong association was found between prior stroke\/TIA and the presence of VaD (aOR 5.89; 95% CI 5.69\u20136.09). Hospitalizations involving all-cause dementia had higher in-hospital mortality (17.06% vs. 7.22%), lower ICU admission rates (1.33% vs. 7.58%), and higher frequencies of palliative-care coding (3.76% vs. 1.65%) than hospitalizations without dementia (Table 3). They also had shorter hospital stays and lower median estimated hospitalization costs (\u20ac6,129.3 vs. \u20ac8,602.94). A comprehensive breakdown of in-hospital mortality according to specific concomitant conditions and dementia status is available in S3 Table.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among T2DM-related hospitalizations with dementia, female sex was associated with lower adjusted odds of in-hospital mortality. Prior stroke or transient ischemic attack was strongly associated with vascular dementia coding. Lower ICU admission and higher palliative-care coding were observed among hospitalizations involving dementia; however, the clinical reasons underlying these patterns cannot be determined from administrative discharge data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358874","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:44:36Z","timestamp":1790271876000},"page":"e0358874","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide trends in dementia subtypes and in-hospital mortality among hospitalizations with type 2 diabetes in Spain, 2021\u20132024: A focus on sex disparities"],"prefix":"10.1371","volume":"21","author":[{"given":"Natividad","family":"Cuadrado-Corrales","sequence":"first","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0323-2443","authenticated-orcid":true,"given":"Diana Mar\u00eda","family":"M\u00e9rida","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Lopez-de-Andres","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)","place":["Madrid, Spain"]},{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Pharmacy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0686-4208","authenticated-orcid":true,"given":"Jose J.","family":"Zamorano-Leon","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Jimenez-Garcia","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Carabantes-Alarcon","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Bodas-Pinedo","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Hernandez-Barrera","sequence":"additional","affiliation":[{"name":"Universidad Rey Juan Carlos","place":["Madrid, Spain"],"department":["Preventive Medicine and Public Health Teaching and Research Unit, Faculty of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Fuentes-Arroyo","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid","place":["Madrid, Spain"],"department":["Department of Public Health and Maternal & Child Health, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"pone.0358874.ref001","unstructured":"Diabetes Atlas [Internet]. 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