Cognitive Impairment and Prevalence of Memory-Related Diagnoses among U.S. Older Adults

Cognitive impairment creates significant challenges to health and well-being of the fast-growing
aging population. Early recognition of cognitive impairment may confer important advantages,
allowing for diagnosis and appropriate treatment, education, psychosocial support, and improved
decision-making regarding life planning, health care, and financial matters. Yet the prevalence of
memory-related diagnoses among older adults with early symptoms of cognitive impairment is
unknown. Using 2000-2014 Health and Retirement Survey - Medicare linked data, we leveraged
within-individual variation in a longitudinal cohort design to examine the relationship between
incident cognitive impairment and receipt of diagnosis among American older adults. Receipt of
a memory-related diagnosis was determined by ICD-9-CM codes. Incident cognitive impairment
was assessed using the modified Telephone Interview of Cognitive Status (TICS). We found
overall low prevalence of early memory-related diagnosis, or high rate of underdiagnosis, among
older adults showing symptoms of cognitive impairment, especially among non-whites and
socioeconomically disadvantaged subgroups. Our findings call for targeted interventions to
improve the rate of early diagnosis, especially among vulnerable populations.