Treatment patterns and burden of behavioral disturbances in patients with dementia in the United States: a claims database analysis
Open accessAbstract
BACKGROUND: Although patients with dementia frequently experience neuropsychological symptoms (NPS) such as agitation, which profoundly impacts patients, caregivers, and the healthcare system, few studies have evaluated the associated burden of agitation or agitation-related symptoms in dementia. METHODS: This retrospective analysis of claims data from the Truven Health MarketScan® database (2012-2015) compared clinical characteristics, treatment patterns, healthcare resource utilization, and costs among patients with dementia with behavioral disturbances (BD) versus patients with dementia without BD. Existing BD diagnosis codes 294.11 or 294.21 were used as a means to identify patients with agitation/agitation-related symptoms. RESULTS: From a starting sample of 6.4 million beneficiaries, 103,402 patients with dementia were identified, of whom 16,440 (16%) had BD during an average of 17 months of follow-up. Patients with BD had significantly more medical and psychiatric comorbidities and greater comedication use (i.e., antidementia drugs, antidepressants, and antipsychotics; all values, P < .0001) compared with patients without BD. A significantly greater number of hospitalizations, hospital days, outpatient hospital/clinic visits, number of skilled nursing visits, and number of patients with hospice visit were reported during follow-up in patients with BD compared with patients without BD (all values, P < 0.0001). Costs were also significantly higher among patients with BD versus those patients without BD ($42,284 vs. $32,640, respectively; P < 0.0001). CONCLUSIONS: Patients with dementia with BD had a higher prevalence of comorbidities, greater use of comedications, and greater healthcare utilization and costs than patients with dementia without BD.
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Larger proportions of individuals with dementia and behavioral disturbances used antihypertensives, dementia treatments, antipsychotics, antidepressants, antiepileptics, and hypnotics compared with individuals with dementia but without behavioral disturbances.
“This group of researchers also found that larger proportions of individuals with dementia and behavioral disturbances used medications including antihypertensives, dementia treatments, antipsychotics, antidepressants, antiepileptics and hypnotics compared with individuals with dementia but without behavioral disturbances.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [884]
The Results section, “Common concomitant medications at baseline” (page unavailable), reports higher proportions of patients with behavioral disturbances using antidementia drugs, antidepressants, antipsychotics, and hypnotics. “Psychotropic treatment patterns” also reports higher use of anticonvulsants. The copy lists antihypertensives among the medication categories shown in Figure 2 but does not state that their use was higher in the behavioral-disturbance group. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOne group of researchers found that individuals with dementia and behavioral disturbances, such as agitation, had more psychiatric comorbidities than individuals with dementia but without behavioral disturbances.
“Additionally, one group of researchers found that individuals with dementia and behavioral disturbances, such as agitation, had more psychiatric comorbidities than individuals with dementia but without behavioral disturbances. 884”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [884]
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Machine Learning Prediction of One‐Year Rehospitalization in Dementia: A Retrospective Cohort Study
Esmaeili, A., Saeedi, V., & Kamalzadeh, L. (2026) · Health Science Reports · doi:10.1002/hsr2.73203
“Behavioral and psychological symptoms of dementia (BPSD), such as agitation, aggression, and psychosis, have also been linked to increased emergency service use and institutionalization [9, 10].”
- Authors
- Aigbogun, M. S., Stellhorn, R., Hartry, A., Baker, R. A., & Fillit, H.
- Affiliations
- Otsuka (United States) (US)
- Lundbeck (United States) (US)
- Alzheimer's Drug Discovery Foundation (US)
- Corresponding author
- Aigbogun, Myrlene Sanon
- Venue
- BMC Neurology
- Published
- 2019-02-28
- Volume
- 19
- Issue
- 1
- Pages
- 33-33
- ISSN
- 1471-2377 (ISSN-L)
- PMC
- PMC6396493
- OpenAlex
- W2927028955
- Cited by
- 46
- References
- 33
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 8 · 2023: 5 · 2022: 10 · 2021: 7 · 2020: 7 · 2019: 1
- FWCI
- 6.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Neurology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Otsuka America Pharmaceutical
- Otsuka America
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia, behavioral problems, agitation, neuropsychological symptoms, healthcare resource utilization, health care costs, comorbidities, concomitant medications, antipsychotic drugs, antidepressants, hospitalization, skilled nursing care, hospice care
- MeSH terms
- Problem Behavior, Aged, Dementia, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Retrospective Studies, United States, Comorbidity, Prevalence, Databases, Factual, Health Care Costs, Cost of Illness
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