Mortality of people with diagnosed dementia in Germany between 2016 and 2021

BACKGROUND: Germany's aging population, driven by rising life expectancy and declining birth rates, has resulted in an increasing number of elderly individuals and various health-related challenges, with dementia being one of the most prevalent chronic diseases. Dementia is an umbrella term encompassing various medical conditions that cause progressive cognitive decline. It is linked to a substantially higher risk of death. However, data on the mortality of dementia in Germany are limited. Therefore, this study aims to estimate the all-cause mortality and mortality rate ratio (MRR) of individuals diagnosed with dementia between 2016 and 2021. METHODS: The age- and sex-specific mortality of people with dementia aged 65 and older, as well as the MRR between the years 2016 and 2021, were estimated using a partial differential equation. The estimation relied on the incidence and prevalence of dementia diagnoses among individuals covered by statutory health insurance and on mortality in the general German population, sourced from the German Federal Statistical Office. RESULTS: The standardized overall mortality of individuals diagnosed with dementia increased slightly from 18,845 to 20,238 per 100,000, reflecting a rise of 7.4% between 2016 and 2021, with males typically showing higher rates. Overall, mortality increases exponentially with age. However, the age-related mortality rates remained relatively stable from 2016 to 2021, with only a slight upward trend. Individuals with dementia had a higher risk of death compared to individuals without dementia. Females diagnosed with dementia had up to 11 times higher risk of death compared to those not diagnosed with dementia at the same age, while for males it was up to 9 times higher. This difference was most pronounced in the 65- to 70-year age group, but diminished with increasing age. CONCLUSIONS: A dementia diagnosis is associated with increased mortality across all age groups, particularly among younger individuals, although the relative risk declines with age as dementia becomes one of several comorbidities. Targeted interventions to prevent dementia, delay onset, and prolong milder stages remain essential to reduce mortality of people with dementia.