@article {13422, title = {Association between perceived risk of Alzheimer{\textquoteright}s disease and related dementias and cognitive function among U.S. older adults.}, journal = {Arch Gerontol Geriatr}, volume = {115}, year = {2023}, pages = {105126}, abstract = {

INTRODUCTION: The aim of the study was to assess factors associated with the perceived risk of developing Alzheimer{\textquoteright}s disease and related dementias (ADRD) and how the perceived risk of ADRD was related to cognitive function.

METHODS: We conducted a retrospective cohort study using 5 waves of data from the Health and Retirement Study (2012-2022) that included adults aged 65 years or older with no previous diagnosis of ADRD at baseline. Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7{\textquoteright}s test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range~=~0-35). Perceived risk of developing ADRD was categorized at baseline as "definitely not" (0\% probability), "unlikely" (1-49\%), "uncertain" (50\%), and "more than likely" (>50-100\%). Additional baseline measures included participants{\textquoteright} sociodemographic background, psychosocial resources, health behaviors, physiological status, and healthcare utilization.

RESULTS: Of 1457 respondents (median age 74 [IQR~=~69-80] and 59.8\% women), individuals who perceived that they were "more than likely" to develop ADRD had more depressive symptoms and were more likely to be hospitalized in the past two years than individuals who indicated that it was "unlikely" they would develop ADRD. Alternatively, respondnets who perceived that they would "definitely not" develop ADRD were more likely to be non-Hispanic Black, less educated, and have lower income than individuals who indicated it was "unlikely" they would develop ADRD. Respondents who reported their risks of developing ADRD as "more than likely" (β~=~-2.10, P~<~0.001) and "definitely not" (β~=~-1.50, P~<~0.001) had the lowest levels of cognitive function; and the associations were explained in part by their socioeconomic, psychosocial, and health status.

CONCLUSIONS: Perceived risk of developing ADRD is associated with cognitive function. The (dis)concordance between individuals{\textquoteright} perceived risk of ADRD and their cognitive function has important implications for increasing public awareness and developing interventions to prevent ADRD.

}, keywords = {Alzheimer{\textquoteright}s disease, cognitive function, Dementia, Older Adults, United States}, issn = {1872-6976}, doi = {10.1016/j.archger.2023.105126}, author = {Wang, Nan and Xu, Hanzhang and West, Jessica S and {\O}stbye, Truls and Wu, Bei and Xian, Ying and Dupre, Matthew E} } @article {7403, title = {The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited.}, journal = {J Alzheimers Dis}, volume = {17}, year = {2009}, month = {2009}, pages = {807-15}, publisher = {17}, abstract = {

Our study estimates the sensitivity and specificity of Medicare claims to identify clinically-diagnosed dementia, and documents how errors in dementia assessment affect dementia cost estimates. We compared Medicare claims from 1993-2005 to clinical dementia assessments carried out in 2001-2003 for the Aging Demographics and Memory Study (ADAMS) cohort (n = 758) of the Health and Retirement Study. The sensitivity and specificity of Medicare claims was 0.85 and 0.89 for dementia (0.64 and 0.95 for AD). Persons with dementia cost the Medicare program (in 2003) $7,135 more than controls (P < 0.001) when using claims to identify dementia, compared to $5,684 more when using ADAMS (P < 0.001). Using Medicare claims to identify dementia results in a 110\% increase in costs for those with dementia as compared to a 68\% increase when using ADAMS to identify disease, net of other variables. Persons with false positive Medicare claims notations of dementia were the most expensive group of subjects ($11,294 versus $4,065, for true negatives P < 0.001). Medicare claims overcount the true prevalence of dementia, but there are both false positive and negative assessments of disease. The use of Medicare claims to identify dementia results in an overstatement of the increase in Medicare costs that are due to dementia.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Cohort Studies, Dementia, Female, Health Care Costs, Humans, Insurance Claim Reporting, Male, Medicare, Prevalence, Sensitivity and Specificity, United States}, issn = {1875-8908}, doi = {10.3233/JAD-2009-1099}, author = {Donald H. Taylor Jr. and {\O}stbye, Truls and Kenneth M. Langa and David R Weir and Brenda L Plassman} }