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

Siddharth Jain; Paul R Rosenbaum; Joseph G Reiter; Geoffrey Hoffman; Dylan S Small; Jinkyung Ha; Alexander S Hill; David A Wolk; Timothy Gaulton; Mark D Neuman; Roderic G Eckenhoff; Lee A Fleisher; Jeffrey H Silber

doi:10.1002/alz.12199

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

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

Authors

Siddharth Jain^{1

2}, Paul R Rosenbaum^{2

3}, Joseph G Reiter¹, Geoffrey Hoffman^{4

5}, Dylan S Small^{2

3}, Jinkyung Ha⁶, Alexander S Hill¹, David A Wolk⁷, 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

¹ Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
² The Leonard Davis Institute of Health Economics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Department of Statistics, The Wharton School, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
⁵ University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan, USA.
⁶ Division of Geriatric and Palliative Medicine, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
⁷ Department of Neurology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁸ Center for Perioperative Outcomes Research and Transformation, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁹ Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
¹⁰ The Departments of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
¹¹ Department of Health Care Management, The Wharton School, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.

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.

Abstract

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