Feride H. Frech, G. Li, T. Juday, Y. Ding, S. Mattke, A. Khachaturian, A. S. Rosenberg, C. Ndiba-Markey, A. Rava, R. Batrla, S. De Santi, H. Hampel
{"title":"美国从轻度认知障碍发展到阿尔茨海默病的经济影响","authors":"Feride H. Frech, G. Li, T. Juday, Y. Ding, S. Mattke, A. Khachaturian, A. S. Rosenberg, C. Ndiba-Markey, A. Rava, R. Batrla, S. De Santi, H. Hampel","doi":"10.14283/jpad.2024.68","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Limited evidence exists on the economic burden of individuals who progress from mild cognitive impairment (MCI) to Alzheimer disease and related dementia disorders (ADRD).</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To assess the all-cause health care resource utilization and costs for individuals who develop ADRD following an MCI diagnosis compared to those with stable MCI.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>This was a retrospective cohort study from January 01, 2014, to December 31, 2019.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>The Merative MarketScan Commercial and Medicare Databases were used.</p><h3 data-test=\"abstract-sub-heading\">Participants</h3><p>Individuals were included if they: (1) were aged 50 years or older; (2) had ≥1 claim with an MCI diagnosis based on the International Classification of Diseases, Ninth Revision (ICD-9) code of 331.83 or the Tenth Revision (ICD-10) code of G31.84; and had continuous enrollment. Individuals were excluded if they had a diagnosis of Parkinson’s disease or ADRD or prescription of ADRD medication.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>Outcomes included all-cause utilization and costs per patient per year in the first 12 months following MCI diagnosis, in total and by care setting: inpatient admissions, emergency department (ED) visits, outpatient visits, and pharmacy claims.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Out of the total of 5185 included individuals, 1962 (37.8%) progressed to ADRD (MCI-to-ADRD subgroup) and 3223 (62.2%) did not (Stable MCI subgroup). Adjusted all-cause utilization was higher for all care settings in the MCI-to-ADRD subgroup compared with the Stable MCI subgroup. Adjusted all-cause mean total costs ($34599 vs $24541; mean ratio [MR], 1.41 [95% CI, 1.31–1.51]; P<.001), inpatient costs ($47463 vs $38004; MR, 1.25 [95% CI, 1.08–1.44]; P=.002), ED costs ($4875 vs $3863; MR, 1.26 [95% CI, 1.11–1.43]; P<.001), and outpatient costs ($16652 vs $13015; MR, 1.28 [95% CI, 1.20–1.37]; P<.001) were all significantly higher for the MCI-to-ADRD subgroup compared with the Stable MCI subgroup.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Individuals who progressed from MCI to ADRD had significantly higher health care costs than individuals with stable MCI. Early identification of MCI and delaying its progression is important to improve patient and economic outcomes.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"18 1","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Economic Impact of Progression from Mild Cognitive Impairment to Alzheimer Disease in the United States\",\"authors\":\"Feride H. Frech, G. Li, T. Juday, Y. Ding, S. Mattke, A. Khachaturian, A. S. Rosenberg, C. Ndiba-Markey, A. Rava, R. Batrla, S. De Santi, H. Hampel\",\"doi\":\"10.14283/jpad.2024.68\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Background</h3><p>Limited evidence exists on the economic burden of individuals who progress from mild cognitive impairment (MCI) to Alzheimer disease and related dementia disorders (ADRD).</p><h3 data-test=\\\"abstract-sub-heading\\\">Objectives</h3><p>To assess the all-cause health care resource utilization and costs for individuals who develop ADRD following an MCI diagnosis compared to those with stable MCI.</p><h3 data-test=\\\"abstract-sub-heading\\\">Design</h3><p>This was a retrospective cohort study from January 01, 2014, to December 31, 2019.</p><h3 data-test=\\\"abstract-sub-heading\\\">Setting</h3><p>The Merative MarketScan Commercial and Medicare Databases were used.</p><h3 data-test=\\\"abstract-sub-heading\\\">Participants</h3><p>Individuals were included if they: (1) were aged 50 years or older; (2) had ≥1 claim with an MCI diagnosis based on the International Classification of Diseases, Ninth Revision (ICD-9) code of 331.83 or the Tenth Revision (ICD-10) code of G31.84; and had continuous enrollment. Individuals were excluded if they had a diagnosis of Parkinson’s disease or ADRD or prescription of ADRD medication.</p><h3 data-test=\\\"abstract-sub-heading\\\">Measurements</h3><p>Outcomes included all-cause utilization and costs per patient per year in the first 12 months following MCI diagnosis, in total and by care setting: inpatient admissions, emergency department (ED) visits, outpatient visits, and pharmacy claims.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Out of the total of 5185 included individuals, 1962 (37.8%) progressed to ADRD (MCI-to-ADRD subgroup) and 3223 (62.2%) did not (Stable MCI subgroup). Adjusted all-cause utilization was higher for all care settings in the MCI-to-ADRD subgroup compared with the Stable MCI subgroup. Adjusted all-cause mean total costs ($34599 vs $24541; mean ratio [MR], 1.41 [95% CI, 1.31–1.51]; P<.001), inpatient costs ($47463 vs $38004; MR, 1.25 [95% CI, 1.08–1.44]; P=.002), ED costs ($4875 vs $3863; MR, 1.26 [95% CI, 1.11–1.43]; P<.001), and outpatient costs ($16652 vs $13015; MR, 1.28 [95% CI, 1.20–1.37]; P<.001) were all significantly higher for the MCI-to-ADRD subgroup compared with the Stable MCI subgroup.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>Individuals who progressed from MCI to ADRD had significantly higher health care costs than individuals with stable MCI. 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Economic Impact of Progression from Mild Cognitive Impairment to Alzheimer Disease in the United States
Background
Limited evidence exists on the economic burden of individuals who progress from mild cognitive impairment (MCI) to Alzheimer disease and related dementia disorders (ADRD).
Objectives
To assess the all-cause health care resource utilization and costs for individuals who develop ADRD following an MCI diagnosis compared to those with stable MCI.
Design
This was a retrospective cohort study from January 01, 2014, to December 31, 2019.
Setting
The Merative MarketScan Commercial and Medicare Databases were used.
Participants
Individuals were included if they: (1) were aged 50 years or older; (2) had ≥1 claim with an MCI diagnosis based on the International Classification of Diseases, Ninth Revision (ICD-9) code of 331.83 or the Tenth Revision (ICD-10) code of G31.84; and had continuous enrollment. Individuals were excluded if they had a diagnosis of Parkinson’s disease or ADRD or prescription of ADRD medication.
Measurements
Outcomes included all-cause utilization and costs per patient per year in the first 12 months following MCI diagnosis, in total and by care setting: inpatient admissions, emergency department (ED) visits, outpatient visits, and pharmacy claims.
Results
Out of the total of 5185 included individuals, 1962 (37.8%) progressed to ADRD (MCI-to-ADRD subgroup) and 3223 (62.2%) did not (Stable MCI subgroup). Adjusted all-cause utilization was higher for all care settings in the MCI-to-ADRD subgroup compared with the Stable MCI subgroup. Adjusted all-cause mean total costs ($34599 vs $24541; mean ratio [MR], 1.41 [95% CI, 1.31–1.51]; P<.001), inpatient costs ($47463 vs $38004; MR, 1.25 [95% CI, 1.08–1.44]; P=.002), ED costs ($4875 vs $3863; MR, 1.26 [95% CI, 1.11–1.43]; P<.001), and outpatient costs ($16652 vs $13015; MR, 1.28 [95% CI, 1.20–1.37]; P<.001) were all significantly higher for the MCI-to-ADRD subgroup compared with the Stable MCI subgroup.
Conclusions
Individuals who progressed from MCI to ADRD had significantly higher health care costs than individuals with stable MCI. Early identification of MCI and delaying its progression is important to improve patient and economic outcomes.
期刊介绍:
The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.