The Impact of Changes in Population Health and Mortality on Future Prevalence of Alzheimer’s Disease and Other Dementias in the United States

Zissimopoulos, Julie; Tysinger, Bryan; Clair, Patricia A. St.; Crimmins, Eileen M.

doi:10.1093/geronb/gbx147

Cited by 69 publications

(60 citation statements)

References 36 publications

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“…To reduce measurement error in dementia ascertainment based on cognitive scores, we required one wave with dementia and evidence of continued cognitive impairment in the next consecutive wave [6,19]. If the respondent with one wave of dementia died before the next wave, he or she was assumed to have dementia before dying.…”

Section: Methodsmentioning

confidence: 99%

“…Nationally representative surveys are another key source for estimating population dementia prevalence. The Health and Retirement Study (HRS) [4–6] and the National Health and Aging Trends Study have repeatedly used cognitive tests to measure dementia prevalence as well as onset in nationally representative cohorts. Cognitive tests for dementia ascertainment from surveys have been criticized for focusing heavily on language and memory [7], being sensitive to education level [8], and for their limited ability to differentiate mild cognitive impairment from dementia [9].…”

Section: Introductionmentioning

confidence: 99%

“…[18] reported that 60% of respondents with “probable” dementia in 2011 National Health and Aging Trends Study data had formal diagnosis in three‐year Medicare claims. None of these studies addressed the measurement error in dementia ascertainment based on survey data that two recent studies showed, and this led to an upward bias in dementia ascertainment [6,19]. They did not address the measurement error in claims data due to the “rule‐out” diagnosis of reversible dementia symptoms (e.g., visual or auditory problems, vitamin B 12 deficiency, thyroid disturbance).…”

Section: Introductionmentioning

confidence: 99%

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Analysis of dementia in the US population using Medicare claims: Insights from linked survey and administrative claims data

Chen

Tysinger

Crimmins

et al. 2019

A&D Transl Res & Clin Interv

118

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Introduction Medicare claims data may be a rich data source for tracking population dementia rates. Insufficient understanding of completeness of diagnosis, and for whom, limits their use. Methods We analyzed agreement in prevalent and incident dementia based on cognitive assessment from the Health and Retirement Study for persons with linked Medicare claims from 2000 to 2008 (N = 10,450 persons). Multinomial logistic regression identified sociodemographic factors associated with disagreement. Results Survey-based cognitive tests and claims-based dementia diagnosis yielded equal prevalence estimates, yet only half were identified by both measures. Race and education were associated with disagreement. Eighty-five percent of respondents with incident dementia measured by cognitive decline received a diagnosis or died within the study period, with lower odds among blacks and Hispanics than among whites. Discussions Claims data are valuable for tracking dementia in the US population and improve over time. Delayed diagnosis may underestimate rates within black and Hispanic populations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of dementia in the US population using Medicare claims: Insights from linked survey and administrative claims data

Chen

Tysinger

Crimmins

et al. 2019

A&D Transl Res & Clin Interv

118

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“…With the increase of the life expectancy, the number of people affected by neurodegenerative diseases is growing. Among these diseases, Alzheimer's disease (AD) is the most diffuse form of dementia [ 26 – 29 ]. Currently, no effective treatment is available.…”

Section: Introductionmentioning

confidence: 99%

Effects of the Aphanizomenon flos-aquae Extract (Klamin®) on a Neurodegeneration Cellular Model

Nuzzo

Presti²,

Picone

et al. 2018

Oxidative Medicine and Cellular Longevity

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Cyanobacteria have been recognized as a source of bioactive molecules to be employed in nutraceuticals, pharmaceuticals, and functional foods. An extract of Aphanizomenon flos-aquae (AFA), commercialized as Klamin®, was subjected to chemical analysis to determine its compounds. The AFA extract Klamin® resulted to be nontoxic, also at high doses, when administered onto LAN5 neuronal cells. Its scavenging properties against ROS generation were evaluated by using DCFH-DA assay, and its mitochondrial protective role was determined by JC-1 and MitoSOX assays. Klamin® exerts a protective role against beta amyloid- (Aβ-) induced toxicity and against oxidative stress. Anti-inflammatory properties were demonstrated by NFβB nuclear localization and activation of IL-6 and IL-1β inflammatory cytokines through ELISA. Finally, by using thioflavin T (ThT) and fluorimetric measures, we found that Klamin® interferes with Aβ aggregation kinetics, supporting the formation of smaller and nontoxic structures compared to toxic Aβ aggregates alone. Altogether, these data indicate that the AFA extract may play a protective role against mechanisms leading to neurodegeneration.

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“…When estimating the impact of changes in the course of the diseases, it is possible that new treatments for Alzheimer's Disease and prevention strategies may result in increased longevity and could eventually lead to higher overall health and care costs, particularly if they slow progression. For example, a simulation model in the US showed that reducing the incidence of some of the risks that have been identified as being associated with dementia, such as diabetes and hypertension, could eventually lead to higher numbers of people living with dementia as a result of increased longevity (Zissimopoulos et al 2018).…”

Section: What Would Be the Impact Of New Dementia Treatments And Prevmentioning

confidence: 99%

Building on Hope or Tackling Fear? Policy Responses to the Growing Costs of Alzheimer's Disease and Other Dementias

Comas-Herrera

2020

SSRN Journal

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In most countries, it is clear that the costs of care, treatment, and support of people with Alzheimer's disease and other dementias will rise considerably in the next few decades. This paper discusses dementia as an economic concern and looks at the policy questions addressed by the current literature on the costs of dementia. It then considers the policy responses to concerns about the growing cost of dementia, distinguishing between 'hopeful' policies that seek to reduce or contain the costs, and policies to address the capacity of the health, care, and social protection systems to respond to dementia care in a way consistent with public expectations. We conclude that the costs of dementia care do not necessarily equate to dementia care being unsustainable, but they do highlight the need for policy action. Additionally, it is relatively easier for policymakers to adopt 'hopeful' policies, such as investment in research to find a disease modifying treatment for Alzheimer's or strategies for dementia risk reduction, than it is to tackle the more politically complex decisions needed to ensure that health, care, and social protection systems have the capacity to respond to the challenge of dementia.

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The Impact of Changes in Population Health and Mortality on Future Prevalence of Alzheimer’s Disease and Other Dementias in the United States

Cited by 69 publications

References 36 publications

Analysis of dementia in the US population using Medicare claims: Insights from linked survey and administrative claims data

Analysis of dementia in the US population using Medicare claims: Insights from linked survey and administrative claims data

Effects of the Aphanizomenon flos-aquae Extract (Klamin®) on a Neurodegeneration Cellular Model

Building on Hope or Tackling Fear? Policy Responses to the Growing Costs of Alzheimer's Disease and Other Dementias

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