Cited by 129Dementia and Cognitive Impairment ResearchMedical Coding and Health InformationHealth Systems, Economic Evaluations, Quality of Life

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

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Chen, Yi, Tysinger, Bryan, Crimmins, Eileen, Zissimopoulos, Julie M.·2019·Alzheimer's & Dementia: Translational Research & Clinical Interventions

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.

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  • Underdiagnosis is higher in Black and Hispanic older adults.

    “Some studies indicate that underdiagnosis is higher in Black and Hispanic older adults.”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [261]

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Authors
Chen, Y., Tysinger, B., Crimmins, E., & Zissimopoulos, J. M.
Affiliations
University of Southern California (US)
Corresponding author
Zissimopoulos, Julie M.
Venue
Alzheimer's & Dementia: Translational Research & Clinical Interventions
Publisher
Wiley
Published
2019-01
Volume
5
Issue
1
Pages
197-207
ISSN
2352-8737 (ISSN-L)
OpenAlex
W2954918532
Cited by
129
References
49
Citations by year
2026: 19 · 2025: 22 · 2024: 17 · 2023: 19 · 2022: 24 · 2021: 20 · 2020: 7 · 2019: 1
FWCI
10.36
Type
journal article
Language
en
Open access
Locations
  • Alzheimer s & Dementia Translational Research & Clinical Interventions (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • National Institutes of Health
  • National Institute on Aging (1R01AG055401)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
dementia, Medicare claims data, prevalence estimates, incident dementia, cognitive assessment, Health and Retirement Study, racial disparities, Hispanic population, Black population, delayed diagnosis, sociodemographic factors

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