Trends in Recognition and Treatment of Dementia in France Analysis of the 2004 to 2010 Database of the National Health Insurance Plan

Dementia is considered as underdiagnosed. We examined whether the proportion of persons aged 65 years and older who had been diagnosed as demented has changed over a 7-year period. The study population was constituted by a cohort of about 70,000 persons who were representative of the French elderly covered by the national health care insurance plan. Data about all health care consumptions were extracted from the national insurance database. Patients using an antidementia drug, having a special dementia-related coverage status, or both were identified. Annual age-standardized and sex-standardized proportions of recognized dementia cases were estimated. Between 2004 and 2010, the overall standardized proportion of persons recognized as having dementia increased slightly but significantly (P<0.004) from 3.68% to 4.20%. The proportion of persons recognized as demented increased strongly with age. In 2010, it increased from 1.44% at age 70-74 to 10% at age more than 90 in men and from 1.30% to 17.0% in women. The proportion of cholinesterase inhibitor users decreased after the age of 85 years, whereas memantine use continued to increase. Our study suggested that, in 2010, >75% of the demented persons had been recognized and received pharmacological or/and nonpharmacological therapies for dementia.