[Prevalence of Dementia and Cognitive Decline in Portuguese Residential Care Homes: A Cross-Sectional Study].

INTRODUCTION

Dementia is one of the leading causes of dependency among older people and poses a critical challenge for long-term care systems. Despite the importance of the issue, national data on the prevalence of dementia in residential care homes remain limited.

METHODS

A cross-sectional, observational, and institution-based study was conducted within the framework of the SINDIA project. The study was based on an online survey addressed to the technical directors of residential care homes for older people in Portugal, carried out between January and July 2024. The questionnaire collected information on institutional characteristics (sector, territorial location, base monthly fee, dementia specialization, and total number of residents) and on the prevalence of formally diagnosed dementia cases and of cognitive decline without a recorded diagnosis. Data were analyzed using the R software (version 4.1.2). Mean percentages and 95% confidence intervals (Student's t-method), weighted by NUTS-2 region, were calculated. A hierarchical cluster analysis (Ward's method) was also performed to identify distinct institutional profiles.

RESULTS

On average, 31.7% of residents had a formal dementia diagnosis and 22.3% showed signs of undiagnosed cognitive decline, resulting in 50.2% of the resident population presenting some degree of cognitive impairment, after data cleaning. The proportion varied across territories, institutional sectors, monthly fees and self-reported specialization. A cluster analysis identified three distinct institutional profiles, with a majority group of facilities characterized by lower diagnostic formalization, especially in the non-profit sector and among lower-cost institutions.

CONCLUSION

The findings are suggestive of a very high prevalence of cognitive impairment in Portuguese residential care homes. These results highlight the need for public policies aimed at improving early diagnosis, enhancing staff training, and reducing territorial and institutional inequalities in the response to dementia.