Year: 2023 | Month: October | Volume: 13 | Issue: 10 | Pages: 251-257
DOI: https://doi.org/10.52403/ijhsr.20231034
Dementia Related Deaths: A Multiple Cause Coding Study
Dr. Peter Harteloh
Department of Health and Care Statistics Netherlands, The Hague, The Netherlands.
ABSTRACT
Background: A multiple cause coding of death certificates is a new way of looking at mortality statistics. Death is attributed to a network of interacting pathological conditions, not just to one disease. For dementia - the leading cause of death in many countries today - this implies a revaluation on its role as cause of death.
Methods: All records mentioning dementia in the 2014-2017 Dutch cause-of-death registry were selected (n = 98 718, 18% of all records). Two internationals agreed on measures for multiple cause coding were calculated: the standardized rate of dementia begin mentioned versus dementia being underlying cause of death (SRMU) and the cause of death association index (CDAI) for relationships between dementia and other diseases or disorders mentioned on the same death certificate.
Results: Dementia was the underlying cause of death in 59% of the death certificates mentioning dementia. The SRMU was 1.68 for all forms of dementia and decreased with an increase of diagnostic specification. For men the SRMU was higher than for women. With regard to all causes being mentioned on a death certificate, several clusters causing death could be identified: 1. Dementia associated with cachexia and dehydration, 2. Dementia associated with infections (pneumonia, urinary tract), 3. Dementia associated with falls, 4. Dementia associated with cardiovascular disorders.
Conclusion: Considering a cluster of diseases as cause of death is a more meaningful way to study mortality in a 21st Century population than selecting just one underlying cause of death per deceased.
Key words: Dementia, Cause of death, Multiple cause coding, Mortality statistics, SRMU, CDAI