Time Trends in the Prevalence of Neurocognitive Disorders and Cognitive Impairment in the United States: The Effects of Disease Severity and Improved Ascertainment.
Published
Journal Article
BACKGROUND: Trends in the prevalence of cognitive impairment (CI) based on cognitive assessment instruments are often inconsistent with those of neurocognitive disorders (ND) based on Medicare claims records. OBJECTIVE: We hypothesized that improved ascertainment and resulting decrease in disease severity at the time of diagnosis are responsible for this phenomenon. METHODS: Using Medicare data linked to the Health and Retirement Study (1992-2012), we performed a joint analysis of trends in CI and ND to test our hypothesis. RESULTS: We identified two major contributors to the divergent directions in CI and ND trends: reductions in disease severity explained more than 60% of the differences between CI and ND prevalence over the study period; the remaining 40% was explained by a decrease in the fraction of undiagnosed individuals. DISCUSSION: Improvements in the diagnoses of ND diseases were a major contributor to reported trends in ND and CI. Recent forecasts of CI and ND trends in the U.S. may be overly pessimistic.
Full Text
Duke Authors
- Akushevich, Igor
- Krauchanka, Yuliya
- Stallard, Patrick J. Eric
- Ukraintseva, Svetlana
- Yashin, Anatoli I.
- Yashkin, Arseniy
Cited Authors
- Akushevich, I; Yashkin, AP; Kravchenko, J; Ukraintseva, S; Stallard, E; Yashin, AI
Published Date
- 2018
Published In
Volume / Issue
- 64 / 1
Start / End Page
- 137 - 148
PubMed ID
- 29865067
Pubmed Central ID
- 29865067
Electronic International Standard Serial Number (EISSN)
- 1875-8908
Digital Object Identifier (DOI)
- 10.3233/JAD-180060
Language
- eng
Conference Location
- Netherlands