MedicalResearch.com Interview with:
Pei-Jung Lin, Ph.D.
Center for the Evaluation of Value and Risk in Health
Institute for Clinical Research and Health Policy Studies
Tufts Medical Center
Boston, MA 02111
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Alzheimer’s disease (AD) is a slow, progressive disease. Many people with AD may live for years with the disease left unrecognized or untreated, in part because the early symptoms are mild and often mistaken as part of normal aging. In this study, we found that Alzheimer’s patients may use more health care services and incur higher costs than those without dementia even before they receive a formal diagnosis. For example, total Medicare expenditures were 42% higher among Alzheimer’s patients than matched controls during the year prior to diagnosis ($15,091 vs. $10,622), and 192% higher in the first year immediately following diagnosis ($27,126 vs. $9,274). We also found similar trends among Medicare patients with mild cognitive impairment (MCI)— a prodromal stage of AD and associated with higher dementia risk.
Our study suggests that an Alzheimer’s disease or MCI diagnosis appears to be prompted by other health problems such as cardiovascular and cerebrovascular diseases, pneumonia, renal failure, urinary tract infections, and blood and respiratory infections. This finding likely reflects a failure of ambulatory care related to the impact of cognitive impairment on other chronic conditions.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings highlight the importance of early diagnosis of cognitive impairment and the need for effective care management of its impact on comorbidities. Because Alzheimer’s disease and MCI patients may make multiple transitions in and out of hospitals, post-acute facilities and their homes, there is a clear need to better manage care transitions.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future studies should examine how Medicare Part D prescription drug expenditures, long-term care costs, out-of-pocket spending, informal care costs, and caregiver burden change when individuals transition to MCI and AD.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Lin PJ, Zhong Y, Fillit HM, Chen E, Neumann PJ. Medicare Expenditures of Individuals with Alzheimer’s Disease and Related Dementias or Mild Cognitive Impairment Before and After Diagnosis. J Am Geriatr Soc. 2016 Jun 13. doi:10.1111/jgs.14227. [Epub ahead of print]
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