Epidemiology of Dementia in the Campania Region (Italy): A 2015-2020 population-based study

Abstract As the global population ages, dementia poses a significant health challenge, ranking seventh among leading causes of death worldwide. Considering the high societal and financial burden of dementia, our study aims to provide estimates of prevalence and incidence for any dementia and Alzheimer’s dementia (AD) in the Campania Region (South Italy). It is Population-based study, using routinely collected healthcare data of individuals living in the Campania Region (South Italy) from 2015 to 2020. We included individuals aged ≥65 years who had at least one administrative record for dementia and/or AD. Prevalence rates adjusted for age and sex used 2020 European population as reference. To estimate incidence, we tested three possible algorithms, which differed for the duration of the time interval between study baseline (Jan 1, 2015) and index date (first record for dementia and/or AD in administrative databases). We employed a clinical database for the validation of our algorithms towards neuropsychological test results. Among individuals, 80,392 had dementia, of which 35,748 had AD. The age- and sex-standardized prevalence rates per 1,000 individuals for any dementia and AD were 77.64 (95%CI=77.57; 77.68) and 34.05 (95%CI=34.01; 34.09), respectively. There were 82.10 incident cases of any dementia per 100,000 per year (0.79 sensitivity and 0.62 specificity), and 59.89 incident cases of AD per 100,000 per year (0.80 sensitivity and 0.59 specificity). The capture-recapture method showed low number of undetected cases (1.7% for any dementia and 3.0% for AD). Our algorithms showed acceptable performance with AUC ranging from 0.59 to 0.72, and double likelihood ratio of correctly identifying individuals above and below MMSE standard cut-offs (24 and 26). Our algorithm, integrating administrative and clinical data, holds potential for assessing dementia’s epidemiological burden, identifying risk factors, planning healthcare access, and developing prevention strategies. Key messages • Providing comprehensive estimates of dementia burden aids public health planning and resource allocation. • Integrated administrative and clinical data provide robust tools for epidemiological analysis and preventive strategies.