Open AccessDisease severity at the time of initial cognitive assessment is related to prior health‐care resource use burden
Author(s) -
Desai Urvi,
Kirson Noam Y.,
Lu Yao,
Bruemmer Valerie,
Andrews J. Scott
Publication year - 2020
Publication title -
alzheimer's and dementia: diagnosis, assessment and disease monitoring
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.497
H-Index - 37
ISSN - 2352-8729
DOI - 10.1002/dad2.12093
Subject(s) - medicine , disease , retrospective cohort study , medical record , emergency department , multivariate analysis , severity of illness , health care , emergency medicine , psychiatry , economics , economic growth
Research has shown increased health‐care resource use (HRU) among patients with Alzheimer's disease and related disorders (ADRD) well before diagnosis, but the degree to which HRU is correlated with disease severity at the time of initial assessment is not well documented. Methods Retrospective analysis of linked medical records and claims data for three cohorts: mild ADRD (first [index] Mini‐Mental State Examination [MMSE] ≥20), moderate/severe ADRD (index MMSE < 20), controls without cognitive impairment. HRU during the pre‐index year was compared using multivariate regressions. Results ADRD cohorts had significantly ( P < .01) higher HRU than controls. Compared to mild ADRD patients, moderate/severe ADRD patients had higher rates of hospitalizations (relative risk [RR]: 1.57), emergency department visits (RR: 1.36), potentially avoidable hospitalizations (RR: 1.72), and accidental falls (RR: 1.58). Discussion HRU before initial assessment increases with disease severity at the time of assessment, highlighting the need for timely evaluation and improved management in the earliest stages of ADRD.