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Performance of ICD10 Code-Based Dementia Case Definition in the Health and Retirement Study
Gianattasio KZ, Steffan M, Reist B, Power MC, Rein D.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026-01-13
Topic: Health services, long-term care and technology
STRUCTURED ABSTRACT INTRODUCTION The Dementia DataHub (DDH) reports U.S. dementia prevalence and incidence from Medicare data. Variation in sensitivity, specificity, and accuracy of diagnoses related to geography and participant characteristics complicates interpretation of these data. METHODS We evaluated performance of DDH-defined Medicare claims diagnoses against linked HRS survey-based dementia classifications. RESULTS DDH’s likely-or-higher dementia definition achieved 50% sensitivity, 97% specificity, and 91% accuracy relative to the HRS classification. Sensitivity was higher in urban settings, but patterns varied across census divisions. Respondents with dementia missed in claims were younger and healthier than those correctly identified. DISCUSSION Medicare claims reflecting diagnoses of dementia provide valuable information about who may be receiving dementia treatment and where; however, they often miss cases in ways that differ by geography and patient characteristics. Variation in diagnosis in Medicare claims relative to HRS survey-based dementia classification can be used to improve the value of Medicare diagnoses for surveillance purposes.
Key findings
- RESULTS DDH’s likely-or-higher dementia definition achieved 50% sensitivity, 97% specificity, and 91% accuracy relative to the HRS classification.
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Study details
- Evidence strengthLow
How this study scored 45/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 26 of the 58 points we could judge it on, which is 45 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | 5 / 5 | 2026 — within 1 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 26 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 26 of the 58 points we could judge it on is 45 out of 100. |
| Total | 45 / 100 | — |
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APA 7th
Gianattasio, K. Z., Steffan, M., Reist, B., Power, M. C., & Rein, D. (2026). Performance of ICD10 Code-Based Dementia Case Definition in the Health and Retirement Study. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.64898/2026.01.12.26343791
Vancouver
Gianattasio KZ, Steffan M, Reist B, Power MC, Rein D. Performance of ICD10 Code-Based Dementia Case Definition in the Health and Retirement Study. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2026. doi:10.64898/2026.01.12.26343791.
BibTeX
@article{gianattasio2026-101f0fda,
author = {Gianattasio, K. Z. and Steffan, M. and Reist, B. and Power, M. C. and Rein, D.},
title = {{Performance of ICD10 Code-Based Dementia Case Definition in the Health and Retirement Study}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2026},
doi = {10.64898/2026.01.12.26343791},
url = {https://doi.org/10.64898/2026.01.12.26343791}
}