The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis
Open accessAbstract
Background: With the emergence of disease-modifying Alzheimer’s treatments, timely detection of early-stage disease is more important than ever, as the treatment will not be indicated for later stages. Contemporary population-level data for detection rates of mild cognitive impairment (MCI), the stage at which treatment would ideally start, are lacking, and detection rates for dementia are only available for subsets of the Medicare population. We sought to compare documented diagnosis rates of MCI and dementia in the full Medicare population with expected rates based on a predictive model. Methods: We performed an observational analysis of Medicare beneficiaries aged 65 and older with a near-continuous enrollment over a 3-year observation window or until death using 100% of the Medicare fee-for-service or Medicare Advantage Plans beneficiaries from 2015 to 2019. Actual diagnoses for MCI and dementia were derived from ICD-10 codes documented in those data. We used the 2000–2016 data of the Health and Retirement Study to develop a prediction model for expected diagnoses for the included population. The ratios between actually diagnosed cases of MCI and dementia over number of cases expected, the observed over expected ratio, reflects the detection rate. Results: Although detection rates for MCI cases increased from 2015 to 2019 (0.062 to 0.079), the results mean that 7.4 of 8 million (92%) expected MCI cases remained undiagnosed. The detection rate for MCI was 0.039 and 0.048 in Black and Hispanic beneficiaries, respectively, compared with 0.098 in non-Hispanic White beneficiaries. Individuals dually eligible for Medicare and Medicaid had lower estimated detection rates than their Medicare-only counterparts for MCI (0.056 vs 0.085). Dementia was diagnosed more frequently than expected (1.086 to 1.104) from 2015 to 2019, mostly in non-Hispanic White beneficiaries (1.367) compared with 0.696 in Black beneficiaries and 0.758 in Hispanic beneficiaries. Conclusions: These results highlight the need to increase the overall detection rates of MCI and of dementia particularly in socioeconomically disadvantaged groups.
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“suggesting there may be as many as 8 million people with undiagnosed MCI”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [696]
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“A recent study of Medicare beneficiaries found that only about 8% of expected mild cognitive impairment (MCI) cases are diagnosed on average, suggesting there may be as many as 8 million people with undiagnosed MCI”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [696]
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Cites
Lecanemab in early Alzheimer's disease
van Dyck, C. H., Swanson, C. J., Aisen, P., Bateman, R. J., Chen, C., Gee, M., Kanekiyo, M., Li, D., Reyderman, L., Cohen, S., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2212948 · Cited by 5,678
Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., Bäckman, L., Hänninen, T., Jula, A., Laatikainen, T., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60461-5 · Cited by 3,689 · cited 1×
“These missed and delayed diagnoses have long taken away from patients and families the opportunity to adopt lifestyle changes to reduce the speed of decline [4], start symptomatic medication treatment, and consider measures to increase physical and financial safety and security [5].”
BackgroundDonanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial
Sims, J. R., Zimmer, J. A., Evans, C. D., Lu, M., Ardayfio, P., Sparks, J., Wessels, A. M., Shcherbinin, S., Wang, H., Monkul Nery, E. S., et al. (2023) · JAMA · doi:10.1001/jama.2023.13239 · Cited by 2,932
Rajan, K. B., Weuve, J., Barnes, L. L., McAninch, E. A., Wilson, R. S., & Evans, D. A. (2021) · Alzheimer's & Dementia · doi:10.1002/alz.12362 · Cited by 1,268
Matthews, K. A., Xu, W., Gaglioti, A. H., Holt, J. B., Croft, J. B., Mack, D., & McGuire, L. C. (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2018.06.3063 · Cited by 1,124
Crimmins, E. M., Kim, J. K., Langa, K. M., & Weir, D. R. (2011) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbr048 · Cited by 1,062
Rabinovici, G. D., Gatsonis, C., Apgar, C., Chaudhary, K., Gareen, I., Hanna, L., Hendrix, J., Hillner, B. E., Olson, C., Lesman-Segev, O. H., et al. (2019) · JAMA · doi:10.1001/jama.2019.2000 · Cited by 674 · cited 1×
“In other words, there may be around 10 million Americans with undiagnosed MCI, and around half of them would have the AD pathology [24].”
BackgroundLang, L., Clifford, A., Wei, L., Zhang, D., Leung, D., Augustine, G., Danat, I. M., Zhou, W., Copeland, J. R., Anstey, K. J., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-011146 · Cited by 642 · cited 1×
“This dementia detection rate is much higher than the 38% reported by a meta-analysis of US-based studies prior to 2007 [29] and the July 2022 estimate of 62% from the National Health Service in England [30], but close to a 2.”
ResultTimely Diagnosis for Alzheimer’s Disease: A Literature Review on Benefits and Challenges
Dubois, B., Padovani, A., Scheltens, P., Rossi, A., & Dell’Agnello, G. (2015) · Journal of Alzheimer s Disease · doi:10.3233/jad-150692 · Cited by 565 · cited 1×
“These missed and delayed diagnoses have long taken away from patients and families the opportunity to adopt lifestyle changes to reduce the speed of decline [4], start symptomatic medication treatment, and consider measures to increase physical and financial safety and security [5].”
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Items 101–106 of 106
Discordance Between Cognitive Impairment Status and Claims-Based ADRD Diagnosis
Kim, M. H., Colantonio, L. D., Glymour, M. M., Hamad, R., Adler‐Milstein, J., Kershaw, K. N., Boscardin, W. J., Wang, Z., Oti, A. S., & Howard, V. J. (2026) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000743
Solfrizzi, V., Lozupone, M., & Panza, F. (2026) · Ageing Research Reviews · doi:10.1016/j.arr.2026.103331
Thompson, L. I., Eaton, C., Prieto, S., Lawrence, M., Czech, S. J., Rosenbaum, J., Anthony, D., Chandran, R. F., Kelly, L., Ngo, I., et al. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1823218
“Late onset Alzheimer’s disease (AD), the most common cause of dementia, typically has a slow onset and progression, but the majority of cases still go undetected in primary care (3, 4).”
Structural Brain Imaging for Newly Diagnosed Cognitive Impairment by Medicare Coverage Type
Mattke, S., Liu, Y., Ye, W., & Altunkaynak, K. (2026) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2026.09.002
Self-citationIulita, M. F., Kolachalama, V. B., Brugada-Ramentol, V., Harrison, J., Griffin, N., Benavides, G. A. S., Vera-Campuzano, E., Minguillón, C., Alcolea, D. A., Mackintosh, L., et al. (2026) · EClinicalMedicine · doi:10.1016/j.eclinm.2026.104266
PARASCHIV, A.-C., Spiru, L., Stamate, A., & Mănuc, D. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1969120
Metadata
- Authors
- Mattke, S., Jun, H., Chen, E., Liu, Y., Becker, A., & Wallick, C.
- Affiliations
- University of Southern California (US)
- Harvard University (US)
- Roche (United States) (US)
- Corresponding author
- Mattke, Soeren
- Venue
- Alzheimer's Research & Therapy
- Published
- 2023-07-22
- Volume
- 15
- Issue
- 1
- Pages
- 128-128
- ISSN
- 1758-9193 (ISSN-L)
- PMC
- PMC10362635
- OpenAlex
- W4385075320
- Cited by
- 106
- References
- 38
- Citations by year
- 2026: 32 · 2025: 39 · 2024: 32 · 2023: 3
- FWCI
- 21.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Alzheimer s Research & Therapy (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Genentech, Inc., a member of the Roche Group
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- mild cognitive impairment, dementia, detection rate, underdiagnosis, Medicare beneficiaries, older adults, racial and ethnic disparities, prediction model, ICD-10 diagnoses
- MeSH terms
- Aged, Alzheimer Disease, Medicare, Humans, United States, Cognitive Dysfunction
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