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. 2020 Oct 8:10.1002/alz.12199.
doi: 10.1002/alz.12199. Online ahead of print.

Using Medicare claims in identifying Alzheimer's disease and related dementias

Siddharth Jain  1   2 , Paul R Rosenbaum  2   3 , Joseph G Reiter  1 , Geoffrey Hoffman  4   5 , Dylan S Small  2   3 , Jinkyung Ha  6 , Alexander S Hill  1 , David A Wolk  7 , Timothy Gaulton  2   8   9 , Mark D Neuman  2   8   9 , Roderic G Eckenhoff  8   9 , Lee A Fleisher  2   8   9 , Jeffrey H Silber  1   2   8   9   10   11
Affiliations

Using Medicare claims in identifying Alzheimer's disease and related dementias

Siddharth Jain et al. Alzheimers Dement. .

Abstract

Introduction: This study develops a measure of Alzheimer's disease and related dementias (ADRD) using Medicare claims.

Methods: Validation resembles the approach of the American Psychological Association, including (1) content validity, (2) construct validity, and (3) predictive validity.

Results: We found that four items-a Medicare claim recording ADRD 1 year ago, 2 years ago, 3 years ago, and a total stay of 6 months in a nursing home-exhibit a pattern of association consistent with a single underlying ADRD construct, and presence of any two of these four items predict a direct measure of cognitive function and also future claims for ADRD.

Discussion: Our four items are internally consistent with the measurement of a single quantity. The presence of any two items do a better job than a single claim when predicting both a direct measure of cognitive function and future ADRD claims.

Keywords: Alzheimer's disease; Alzheimer's disease and related dementias; Medicare; Medicare claims; administrative data; cognitive impairment; dementia; health and retirement study.

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Conflict of interest statement

Declaration of Interest: None

Figures

Figure 1.
Figure 1.. Schematic summary: Study design and Coding Scheme
The figure shows the study design and the definition of ADRD based on the claims-based algorithm. In an example, it shows a three year look-back period from age 85 for six patients. The appearance of an ADRD code in claims for each patient is marked ‘|’ The shaded horizontal bar shows stay in a nursing home. The scores based on the 4 indicators are shown in the right column. Patients with a score of ≥2 are labeled as ADRD.
See this image and copyright information in PMC

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