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@ARTICLE{Spijker:280057,
      author       = {Spijker, Jeroen J A and Calazans, Júlia Almeida and
                      Trias-Llimós, Sergi and Renteria, Elisenda and Doblhammer,
                      Gabriele},
      title        = {{E}ducational inequalities in dementia-related mortality
                      using a multiple cause of death approach and their
                      contribution to life expectancy differences in {S}pain.},
      journal      = {Scientific reports},
      volume       = {15},
      number       = {1},
      issn         = {2045-2322},
      address      = {[London]},
      publisher    = {Springer Nature},
      reportid     = {DZNE-2025-00894},
      pages        = {26838},
      year         = {2025},
      abstract     = {We examine dementia-related mortality in Spain from 2016 to
                      2021, focusing on its comorbidities and educational
                      inequalities in life expectancy at age 60. Using a multiple
                      cause of death (MCOD) approach, we assess how
                      dementia-related mortality varies by education level and how
                      these differences contribute to disparities in longevity. We
                      used mortality data from the Spanish National Statistics
                      Institute (INE) by level of education from 2016 to 2021 to
                      analyse mortality from dementia-related diseases (ICD-10
                      codes: F01-F03, G30-G31) both as underlying cause of death
                      (UCOD) and as MCOD (irrespective of their position within
                      the death certificate). We estimated age-standardized
                      mortality rates and used life tables and demographic
                      decomposition techniques to assess the impact of
                      dementia-related diseases on educational differences in life
                      expectancy at age 60. Results showed that in 2016-21 MCOD
                      dementia-related deaths accounted for $17\%$ of all deaths
                      occurring after the age of 60 (men: $11\%;$ women $21\%).$
                      The higher MCOD dementia-related mortality experienced by
                      the lower educated group contributed 0.13 years $(8.4\%)$ to
                      the total life expectancy gap at age 60 between the low and
                      high education groups for men, and 0.26 years $(22.7\%)$ for
                      women. Educational gradients in dementia-related mortality
                      in Spain highlight the importance of disentangling risk
                      factors from a socioeconomic perspective. Moreover, the MCOD
                      approach provides a more realistic estimate of the impact of
                      dementia-related diseases on life expectancy, bringing
                      insights into the burden of ageing-related diseases.},
      keywords     = {Humans / Dementia: mortality / Spain: epidemiology / Life
                      Expectancy / Female / Male / Aged / Educational Status /
                      Middle Aged / Cause of Death / Aged, 80 and over /
                      Socioeconomic Factors / Decomposition (Other) / Dementia
                      (Other) / Education (Other) / Inequalities (Other) /
                      Multiple causes of death (Other)},
      cin          = {AG Doblhammer},
      ddc          = {600},
      cid          = {I:(DE-2719)1012002},
      pnm          = {354 - Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-354},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40702031},
      doi          = {10.1038/s41598-025-10079-x},
      url          = {https://pub.dzne.de/record/280057},
}