Our goal was to determine if frequency of vascular dementia (VD) has declined regionally between 2006 to 2014.

It is unclear if success of reduction in stroke rates has also translated to reductions in VD in the United States (US), and if there are regional differences in rates of VD.

The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) Database from 2006-2014 was used for analysis. Primary and secondary VD diagnoses were identified using ICD-9 codes (290.40, 290.41, and 290.43). The Kendall trend test was used to assess for differences in VD frequency over time and regionally (Northeast, Midwest, South, versus West). Multivariable logistic regression was used to control for demographic variables and risk factors of VD.

The total NIS 20% sampling included 69,273,455 patients. The median age of the total was 53 (interquartile range 27 - 72), 55% female, and 34% non-Caucasian. Mean frequency of VD in the entire cohort as a primary diagnosis was 0.03% and 0.21% as a secondary diagnosis. Trend analysis did not detect a significant decrease in VD diagnosis over-time within the total NIS sample as a primary (p=0.15) or secondary diagnosis (p=0.21). The West was the only region with significant change over time, which decreased both as primary (p=0.0491) and secondary diagnosis (p=0.0013).  After controlling for race, age, gender, insurance type, median income of zip code, diagnosis of atrial fibrillation, hyperlipidemia, hypertension, diabetes, and presence of atherosclerosis, the difference in VD rate as a primary diagnosis in the West was significantly lower (p<0.0001), with odds ratio 2.04 [1.92 – 2.16], but not as a secondary diagnosis (p<0.14).