Home › Research › Disparities
Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis
Mattke S, Jun H, Chen E, Liu Y, Becker A, Wallick C.. Alzheimer's research & therapy, 2023-07-22
Topic: Risk, prevention and care in population studies
Background With the emergence of disease-modifying Alzheimer's treatments, timely detection of early-stage disease is more important than ever, as the treatment will not be indicated for later stages. Contemporary population-level data for detection rates of mild cognitive impairment (MCI), the stage at which treatment would ideally start, are lacking, and detection rates for dementia are only available for subsets of the Medicare population. We sought to compare documented diagnosis rates of MCI and dementia in the full Medicare population with expected rates based on a predictive model. Methods We performed an observational analysis of Medicare beneficiaries aged 65 and older with a near-continuous enrollment over a 3-year observation window or until death using 100% of the Medicare fee-for-service or Medicare Advantage Plans beneficiaries from 2015 to 2019. Actual diagnoses for MCI and dementia were derived from ICD-10 codes documented in those data. We used the 2000-2016 data of the Health and Retirement Study to develop a prediction model for expected diagnoses for the included population. The ratios between actually diagnosed cases of MCI and dementia over number of cases expected, the observed over expected ratio, reflects the detection rate. Results Although detection rates for MCI cases increased from 2015 to 2019 (0.062 to 0.079), the results mean that 7.4 of 8 million (92%) expected MCI cases remained undiagnosed. The detection rate for MCI was 0.039 and 0.048 in Black and Hispanic beneficiaries, respectively, compared with 0.098 in non-Hispanic White beneficiaries. Individuals dually eligible for Medicare and Medicaid had lower estimated detection rates than their Medicare-only counterparts for MCI (0.056 vs 0.085). Dementia was diagnosed more frequently than expected (1.086 to 1.104) from 2015 to 2019, mostly in non-Hispanic White beneficiaries (1.367) compared with 0.696 in Black beneficiaries and 0.758 in Hispanic beneficiaries. Conclusions These results highlight the need to increase the overall detection rates of MCI and of dementia particularly in socioeconomically disadvantaged groups.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mattke, S., Jun, H., Chen, E., Liu, Y., Becker, A., & Wallick, C. (2023). Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis. Alzheimer's research & therapy. https://doi.org/10.1186/s13195-023-01272-z
Vancouver
Mattke S, Jun H, Chen E, Liu Y, Becker A, Wallick C. Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis. Alzheimer's research & therapy. 2023. doi:10.1186/s13195-023-01272-z. PMID: 37481563.
BibTeX
@article{mattke2023-37481563,
author = {Mattke, S. and Jun, H. and Chen, E. and Liu, Y. and Becker, A. and Wallick, C.},
title = {{Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis}},
journal = {Alzheimer's research \& therapy},
year = {2023},
doi = {10.1186/s13195-023-01272-z},
pmid = {37481563},
url = {https://doi.org/10.1186/s13195-023-01272-z}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Results Although detection rates for MCI cases increased from 2015 to 2019 (0.062 to 0.079), the results mean that 7.4 of 8 million (92%) expected MCI cases remained undiagnosed.
- The detection rate for MCI was 0.039 and 0.048 in Black and Hispanic beneficiaries, respectively, compared with 0.098 in non-Hispanic White beneficiaries.
- Dementia was diagnosed more frequently than expected (1.086 to 1.104) from 2015 to 2019, mostly in non-Hispanic White beneficiaries (1.367) compared with 0.696 in Black beneficiaries and 0.758 in Hispanic beneficiaries.
- Conclusions These results highlight the need to increase the overall detection rates of MCI and of dementia particularly in socioeconomically disadvantaged groups.
Why it matters
This analysis found that most expected cases of mild cognitive impairment in the Medicare population were not diagnosed, and detection was lower in Black and Hispanic beneficiaries than in non-Hispanic White beneficiaries. This matters because treatment for early-stage disease cannot be given to people who are never detected.
New to this subject? Start with our plain-English guide: Disparities →
Study details
- Evidence strengthLow
How this study scored 51/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer's research & therapy) |
| Journal's citation record | 1 / 4 | Alzheimer s Research & Therapy: journal h-index 146 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 105 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 21.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 4 / 6 | Cited 18.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 3 / 4 | Cited 102 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Christopher J. Wallick: h-index 11 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37481563) |
| Free to read | 2 / 2 | Free to read |
| Total | 51 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s13195-023-01272-z
- PubMed: 37481563
- Original source →
- Free full text: Alzheimer s Research & Therapy →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Related
Studies in the library that share something with this one. The line above each title says what.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 18.
Later studies that cite this one
15 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Disparities
Also tagged “mini-mental”
840 studies in the library carry the topic tag “mini-mental”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 840 tagged studies.