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Alzheimers Dement (N Y). 2019 Jun 6;5:197-207. doi: 10.1016/j.trci.2019.04.003. eCollection 2019.

Analysis of dementia in the US population using Medicare claims: Insights from linked survey and administrative claims data.

Author information

1
Price School of Public Policy, University of Southern California, Los Angeles, CA, USA.
2
Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
3
Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.

Abstract

Introduction:

Medicare claims data may be a rich data source for tracking population dementia rates. Insufficient understanding of completeness of diagnosis, and for whom, limits their use.

Methods:

We analyzed agreement in prevalent and incident dementia based on cognitive assessment from the Health and Retirement Study for persons with linked Medicare claims from 2000 to 2008 (N = 10,450 persons). Multinomial logistic regression identified sociodemographic factors associated with disagreement.

Results:

Survey-based cognitive tests and claims-based dementia diagnosis yielded equal prevalence estimates, yet only half were identified by both measures. Race and education were associated with disagreement. Eighty-five percent of respondents with incident dementia measured by cognitive decline received a diagnosis or died within the study period, with lower odds among blacks and Hispanics than among whites.

Discussions:

Claims data are valuable for tracking dementia in the US population and improve over time. Delayed diagnosis may underestimate rates within black and Hispanic populations.

KEYWORDS:

Cognition; Diagnosis; Disparities; Incidence; Prevalence; Race/ethnicity

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