© 2020 AJA Inc. Objective: To describe patterns of hospitalisation in the years preceding the first (index) admission coded with dementia. Methods: Retrospective longitudinal analysis of hospitalisation preceding an index admission for dementia for 7919 patients and a matched cohort in a regional local health district of New South Wales, Australia, from 1 July 2006 to 31 December 2016. Results: The dementia cohort experienced a sharp increase in frequency of hospitalisation, particularly in the year pre-index, and primarily for falls and urinary tract infections. They also demonstrated more episodes for nervous and musculoskeletal illnesses and injuries than controls and visited emergency department more frequently with neurological illnesses and injuries. Conclusion: Findings highlight opportunities for earlier diagnosis of dementia in hospital, through more targeted screening and follow-up of suspected cases with comprehensive geriatric assessment prior to discharge. This may result in a definitive diagnosis on discharge, allowing for better coordination of ongoing management to prevent unnecessary readmissions.