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Cited by 110Dementia and Cognitive Impairment ResearchHealth Systems, Economic Evaluations, Quality of LifeHealthcare Policy and Management

Direct medical costs and source of cost differences across the spectrum of cognitive decline: A population‐based study

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Leibson, Cynthia L., Long, Kirsten Hall, Ransom, Jeanine E., Roberts, Rosebud O., Hass, Steven L., Duhig, Amy M., Smith, Carin Y., Emerson, Jane A. +2 more·2015·Alzheimer's & Dementia
DOI 10.1016/j.jalz.2015.01.007PMC PMC4543557
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Abstract

Background: Objective cost estimates and source of cost differences are needed across the spectrum of cognition, including cognitively normal (CN), mild cognitive impairment (MCI), newly discovered dementia, and prevalent dementia. Methods: Subjects were a subset of the Mayo Clinic Study of Aging stratified‐random sampling of Olmsted County, MN, residents aged 70 to 89 years. A neurologist reviewed provider‐linked medical records to identify prevalent dementia (review date = index). Remaining subjects were invited to participate in prospective clinical/neuropsychological assessments; participants were categorized as CN, MCI, or newly discovered dementia (assessment date = index). Costs for medical services/procedures 1‐year pre‐index (excluding indirect and long‐term care costs) were estimated using line‐item provider‐linked administrative data. We estimated contributions of care‐delivery site and comorbid conditions (including and excluding neuropsychiatric diagnoses) to between‐category cost differences. Results: Annual mean medical costs for CN, MCI, newly discovered dementia, and prevalent dementia were $6042, $6784, $9431, $11,678, respectively. Hospital inpatient costs contributed 70% of total costs for prevalent dementia and accounted for differences between CN and both prevalent and newly discovered dementia. Ambulatory costs accounted for differences between CN and MCI. Age‐, sex‐, education‐adjusted differences reached significance for CN versus newly discovered and prevalent dementia and for MCI versus prevalent dementia. After considering all comorbid diagnoses, between‐category differences were reduced (e.g., prevalent dementia minus MCI (from $4842 to $3575); newly discovered dementia minus CN (from $3578 to $711)). Following the exclusion of neuropsychiatric diagnoses from comorbidity adjustment, between‐category differences tended to revert to greater differences. Conclusions: Cost estimates did not differ significantly between CN and MCI. Substantial differences between MCI and prevalent dementia reflected high inpatient costs for dementia and appear partly related to co‐occurring mental disorders. Such comparisons can help inform models aimed at identifying where, when, and for which individuals proposed interventions might be cost‐effective.

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Crossref · 10.1016/j.jalz.2015.01.007

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  • In a population-based study of adults age 70 to 89, annual health care costs were significantly higher for individuals with dementia than for those with either mild cognitive impairment (MCI) or without cognitive impairment.

    “In a population-based study of adults age 70 to 89, annual health care costs were significantly higher for individuals with dementia than for those with either mild cognitive impairment (MCI) or without cognitive impairment.732”

    From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [732]

    The Discussion (page not available in our copy) reports significantly higher age-, sex-, and education-adjusted annual costs for prevalent dementia than for MCI or cognitively normal adults. But the paper also distinguishes newly discovered dementia: its costs differed significantly from cognitively normal adults, not from those with MCI. The claim overgeneralizes the significant MCI comparison to everyone with dementia. (LLM, conf=0.88)

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  • In a population-based study of adults age 70 to 89, annual health care costs were significantly higher for individuals with dementia than for those with either mild cognitive impairment or without cognitive impairment.

    “In a population‐based study of adults age 70 to 89, annual health care costs were significantly higher for individuals with dementia than for those with either mild cognitive impairment (MCI) or without cognitive impairment. 878”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [878]

    The Results (§3.2; page not provided) report significantly higher annual direct medical costs for prevalent dementia than for both cognitively normal adults and adults with MCI in models adjusted for age, sex, and education. The claim says “dementia” without distinguishing prevalent from newly discovered dementia; the latter did not have a significant cost difference from MCI. After adjustment for comorbidities, the prevalent-dementia versus MCI difference was also no longer significant. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Health care costs increase with the presence of dementia.

    “Health care costs increase with the presence of dementia.”

    From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [732]

  • Annual health care costs for individuals with mild cognitive impairment were not significantly different from costs for individuals without cognitive impairment.

    “Annual health care costs for individuals with MCI were not significantly different, however, from costs for individuals without cognitive impairment.”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [878]

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3 of the 81 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [64]Cohen SB Uberoi N Differentials in the concentration in the level of health expenditures across population subgroups in the U.S. 2010 Medical Expenditure Panel Survey 8 2013 Statistical Brief #471 Available on-line at http://meps.ahrq.gov/mepsweb/data_files/publications/st421/stat421.shtml. September 21, 2014 29708701

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Authors
Leibson, C. L., Long, K. H., Ransom, J. E., Roberts, R. O., Hass, S. L., Duhig, A. M., Smith, C. Y., Emerson, J. A., Pankratz, V. S., & Petersen, R. C.
Affiliations
  • Mayo Clinic (US)
  • K Long Health Economics Consulting LLC St. Paul MN USA
  • AbbVie (United States) (US)
Corresponding author
Leibson, Cynthia L.
ORCID
Venue
Alzheimer's & Dementia
Publisher
Wiley
Published
2015-04-06
Volume
11
Issue
8
Pages
917-932
ISSN
  • 1552-5260 (ISSN-L)
  • 1552-5279
DOI
10.1016/j.jalz.2015.01.007
PMC
PMC4543557
OpenAlex
W2114983566
Cited by
110
References
81
Citations by year
2026: 9 · 2025: 14 · 2024: 13 · 2023: 10 · 2022: 15 · 2021: 19 · 2020: 7 · 2019: 5 · 2018: 8 · 2017: 6 · 2016: 4
FWCI
4.87
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alzheimer s & Dementia (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging
  • National Institutes of Health (R01 AG034676)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
direct medical costs, mild cognitive impairment
MeSH terms
Aged, Aged, 80 and over, Aging, Cognition Disorders, Cross-Sectional Studies, Dementia, Female, Humans, Male, Neuropsychological Tests, Patient Acceptance of Health Care, Databases, Factual, Health Care Costs, Disease Progression, Community Health Planning

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