Longitudinal analysis of dementia diagnosis and specialty care among racially diverse Medicare beneficiaries.
Alzheimer's disease
Dementia specialist
Dementia subtype
Diagnosis
Disparities
Unspecified dementia
Journal
Alzheimer's & dementia : the journal of the Alzheimer's Association
ISSN: 1552-5279
Titre abrégé: Alzheimers Dement
Pays: United States
ID NLM: 101231978
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
17
04
2019
revised:
20
06
2019
accepted:
01
07
2019
pubmed:
9
9
2019
medline:
1
9
2020
entrez:
9
9
2019
Statut:
ppublish
Résumé
There is insufficient understanding of diagnosis of etiologic dementia subtypes and contact with specialized dementia care among older Americans. We quantified dementia diagnoses and subsequent health care over five years by etiologic subtype and physician specialty among Medicare beneficiaries with incident dementia diagnosis in 2008/09 (226,604 persons/714,015 person-years). Eighty-five percent of people were diagnosed by a nondementia specialist physician. Use of dementia specialists within one year (22%) and five years (36%) of diagnosis was low. "Unspecified" dementia diagnosis was common, higher among those diagnosed by nondementia specialists (33.2%) than dementia specialists (21.6%). Half of diagnoses were Alzheimer's disease. Ascertainment of etiologic dementia subtype may inform hereditary risk and facilitate financial and care planning. Use of dementia specialty care was low, particularly for Hispanics and Asians, and associated with more detection of etiological subtype. Dementia-related professional development for nonspecialists is urgent given their central role in dementia diagnosis and care.
Identifiants
pubmed: 31494079
pii: S1552-5260(19)35126-X
doi: 10.1016/j.jalz.2019.07.005
pmc: PMC6874742
mid: NIHMS1535362
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1402-1411Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL126804
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL130462
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG054120
Pays : United States
Organisme : NIA NIH HHS
ID : R34 AG049652
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG043073
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG055401
Pays : United States
Informations de copyright
Copyright © 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
Références
Alzheimer Dis Assoc Disord. 2012 Oct-Dec;26(4):335-43
pubmed: 22156756
Ophthalmic Epidemiol. 2012 Oct;19(5):285-92
pubmed: 22978529
J Gerontol B Psychol Sci Soc Sci. 2018 Apr 16;73(suppl_1):S38-S47
pubmed: 29669100
MedGenMed. 2001 Mar 05;3(2):2
pubmed: 11549951
Alzheimer Dis Assoc Disord. 2009 Oct-Dec;23(4):306-14
pubmed: 19568149
Ann Intern Med. 2014 Jun 3;160(11):791-7
pubmed: 24663815
J Alzheimers Dis. 2015;49(3):617-31
pubmed: 26484931
Alzheimers Dement. 2013 Mar;9(2):141-50
pubmed: 23265826
BMC Geriatr. 2016 Jul 11;16:138
pubmed: 27400711
Alzheimers Dement. 2011 May;7(3):270-9
pubmed: 21514249
JAMA Intern Med. 2019 Feb 1;179(2):161-166
pubmed: 30575846
Alzheimers Dement. 2016 Mar;12(3):216-24
pubmed: 26874595
Am J Public Health. 2015 Feb;105(2):408-13
pubmed: 25033130
BMJ. 2015 Jun 16;350:h3029
pubmed: 26079686
Neurobiol Aging. 2018 May;65:149-157
pubmed: 29494861
Int J Geriatr Psychiatry. 2009 Sep;24(9):895-901
pubmed: 19226529
N Engl J Med. 2013 Apr 4;368(14):1326-34
pubmed: 23550670
JAMA. 2007 Nov 28;298(20):2409-11
pubmed: 18042918
N Engl J Med. 2013 Aug 1;369(5):489
pubmed: 23902509
Arch Neurol. 2007 Jun;64(6):830-5
pubmed: 17562930
Ann Intern Med. 2008 Apr 1;148(7):ITC4-1-ITC4-16
pubmed: 18378944
JAMA Neurol. 2013 Nov;70(11):1396-402
pubmed: 24042491
J Clin Epidemiol. 2002 Sep;55(9):929-37
pubmed: 12393082
J Oncol Pract. 2006 Nov;2(6):281
pubmed: 29447577
BMJ Open. 2017 Aug 28;7(8):e015746
pubmed: 28851777
Alzheimers Dement. 2012 Jan;8(1):22-30
pubmed: 21420366
J Alzheimers Dis. 2009;18(3):691-701
pubmed: 19749406
Ann Intern Med. 2008 Mar 4;148(5):I41
pubmed: 18316749
Ann Intern Med. 2008 Mar 4;148(5):379-97
pubmed: 18316756
Alzheimers Dement. 2015 Mar;11(3):332-84
pubmed: 25984581
Forum Health Econ Policy. 2014 Nov;18(1):25-39
pubmed: 27134606
J Am Geriatr Soc. 2016 Aug;64(8):1540-8
pubmed: 27341454
Am J Manag Care. 2011 Nov;17 Suppl 13:S339-45
pubmed: 22214391
Alzheimers Dement. 2011 Jan;7(1):80-93
pubmed: 21255746
Ann Intern Med. 2014 Aug 5;161(3):ITC1; quiz ITC16
pubmed: 25089871
Alzheimers Dement. 2013 Jul;9(4):472-4
pubmed: 23809368
Am Fam Physician. 2011 Jun 15;83(12):1403-12
pubmed: 21671540