BACKGROUND Studies in some high-income countries have reported a potential decline in the prevalence of dementia. Improvements in cardiovascular health may be contributing to this decline. The objective was to examine trends in prevalence of dementia and survival with dementia for people accessing aged care in Australia. METHODS A retrospective study of older people who accessed long-term care 2008-2014 (n = 348,311) and home care 2005-2014 (n = 188,846) in Australia was developed. The age- and sex-standardized prevalence for dementia by year of access to aged care was determined using direct standardization. Generalized linear models were used to determine change in the prevalence of dementia over time and change in 1-year mortality for people who accessed long-term care. RESULTS The age- and sex-standardized prevalence (95% confidence interval) of dementia declined from 50.0% (49.6, 50.5) in 2008 to 46.6% (46.0, 47.2) in 2014 for people accessing long-term care (absolute change 2008-2014: -3.8 [-4.6, -3.1]) and for people accessing home care from 25.9% (25.0, 26.5) in 2005 to 20.9% (20.2, 21.7) in 2014 (absolute change 2005-2014: -5.2 [-6.2, -4.1]). This decline in dementia occurred in concurrence with a decline in cerebrovascular disease in long-term care but despite the prevalence of hypertension, diabetes, high cholesterol, malnutrition, obesity, depression, and head injury increasing. For people accessing long-term care, 1-year mortality remained stable over time. CONCLUSIONS The decline in prevalence of dementia for people accessing aged care services in Australia is critical to future projection estimates and for planning of services. Further research to determine contributing factors to the decline is needed.

中文翻译：

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澳大利亚获得老年护理服务的痴呆症患病率趋势。

背景技术一些高收入国家的研究报告说，痴呆症的患病率有可能下降。心血管健康的改善可能是导致这种下降的原因。目的是研究在澳大利亚接受老年护理的人的痴呆症患病率和痴呆症生存率的趋势。方法进行了一项回顾性研究，研究了在澳大利亚获得长期护理2008-2014（n = 348,311）和家庭护理2005-2014（n = 188,846）的老年人。老年痴呆症的年龄和性别标准化患病率是通过直接标准化来确定的。使用广义线性模型来确定痴呆症患病率随时间的变化以及接受长期护理的人的1年死亡率的变化。结果老年痴呆症的年龄和性别标准化患病率（95％置信区间）从2008年的50.0％（49.6，50.5）下降到2014年的46.6％（46.0，47.2）（2014-2008年绝对变化） 2014年：-3.8 [-4.6，-3.1]）和获得家庭护理的人数从2005年的25.9％（25.0，26.5）上升到2014年的20.9％（20.2，21.7）（2005-2014的绝对变化：-5.2 [-6.2 ，-4.1]）。痴呆症的减少与长期护理中脑血管疾病的减少同时发生，尽管高血压，糖尿病，高胆固醇，营养不良，肥胖，抑郁和头部受伤的患病率增加。对于获得长期护理的人来说，随着时间的流逝，一年的死亡率保持稳定。结论在澳大利亚，获得老年护理服务的人群的痴呆症患病率下降，对于未来的预测估计和服务规划至关重要。需要进一步研究以确定导致下降的因素。