{ "abstract": "Background: 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 (2021–2024). Methods: 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. Results: 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 5.69–6.09). 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 (€6,129.3 vs. €8,602.94). A comprehensive breakdown of in-hospital mortality according to specific concomitant conditions and dementia status is available in S3 Table. Conclusions: 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.", "abstract_shown": true, "affiliations": [ "Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain", "Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain", "Department of Public Health and Maternal & Child Health, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain", "Preventive Medicine and Public Health Teaching and Research Unit, Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain" ], "article_type": "Research Article", "arxiv": null, "author_total": 9, "authors": [ { "affs": [ 0 ], "name": "Natividad Cuadrado-Corrales" }, { "affs": [ 1 ], "name": "Diana María Mérida" }, { "affs": [ 2 ], "name": "Ana Lopez-de-Andres" }, { "affs": [ 3 ], "name": "Jose J. Zamorano-Leon" }, { "name": "Rodrigo Jimenez-Garcia" }, { "name": "David Carabantes-Alarcon" }, { "name": "Andres Bodas-Pinedo" }, { "name": "Valentin Hernandez-Barrera" }, { "name": "Lucia Fuentes-Arroyo" } ], "bibtex": "https://research.draconitic.com/paper/3gjvav2mtc75q.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0358874", "fulltext_url": null, "id": "3gjvav2mtc75q", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0358874", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2738|Dementia and Cognitive Impairment Research" ], [ "plos", "/Biology and life sciences/Computational biology/Computational neuroscience/Coding mechanisms" ], [ "plos", "/Biology and life sciences/Neuroscience/Cognitive neuroscience/Cognitive neurology/Cognitive impairment" ], [ "plos", "/Biology and life sciences/Neuroscience/Cognitive science/Cognitive neuroscience/Cognitive neurology/Cognitive impairment" ], [ "plos", "/Biology and life sciences/Neuroscience/Computational neuroscience/Coding mechanisms" ], [ "plos", "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus/Type 2 diabetes" ], [ "plos", "/Medicine and health sciences/Medical conditions/Cerebrovascular diseases/Vascular dementia" ], [ "plos", "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus/Type 2 diabetes" ], [ "plos", "/Medicine and health sciences/Medical conditions/Neurodegenerative diseases/Alzheimer's disease" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry/Dementia" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry/Dementia/Alzheimer's disease" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry/Dementia/Vascular dementia" ], [ "plos", "/Medicine and health sciences/Neurology/Cerebrovascular diseases/Vascular dementia" ], [ "plos", "/Medicine and health sciences/Neurology/Cognitive neurology/Cognitive impairment" ], [ "plos", "/Medicine and health sciences/Neurology/Dementia" ], [ "plos", "/Medicine and health sciences/Neurology/Dementia/Alzheimer's disease" ], [ "plos", "/Medicine and health sciences/Neurology/Dementia/Vascular dementia" ], [ "plos", "/Medicine and health sciences/Neurology/Neurodegenerative diseases/Alzheimer's disease" ], [ "plos", "/People and places/Geographical locations/Europe/European Union/Spain" ], [ "plos", "/People and places/Population groupings/Age groups" ] ], "openalex": "W7214170024", "pdf_url": "https://www.sanidad.gob.es/estadEstudios/estadisticas/estadisticas/estMinisterio/SolicitudCMBDdocs/Formulario_Peticion_Datos_RAE_CMBD.pdf", "pmcid": null, "pmid": null, "published": "2026-09-24", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/3gjvav2mtc75q.ris", "sources": [ { "first_seen": "2026-10-30T12:17:43Z", "native_id": "10.1371/journal.pone.0358874", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0358874" } ], "subjects": [ { "field": "biology", "origin": "plos:cognitive neuroscience", "subfield": "neuroscience" }, { "field": "medicine", "origin": "plos:neurology", "subfield": "neurology" }, { "field": "medicine", "origin": "plos:mental health and psychiatry", "subfield": "psychiatry" } ], "title": "Nationwide trends in dementia subtypes and in-hospital mortality among hospitalizations with type 2 diabetes in Spain, 2021–2024: A focus on sex disparities", "title_text": "Nationwide trends in dementia subtypes and in-hospital mortality among hospitalizations with type 2 diabetes in Spain, 2021–2024: A focus on sex disparities", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:43Z", "url": "https://research.draconitic.com/paper/3gjvav2mtc75q", "venue": "PLOS One", "versions": [] }