Trends in detection of dementia among beneficiaries in Medicare advantage and traditional Medicare.
5 affiliations
- 1Department of Health Policy and Management Yale University New Haven Connecticut USA.
- 2Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA.
- 3Department of Biostatistics Yale School of Public Health New Haven Connecticut USA.
- 4Yale Alzheimer's Disease Research Center New Haven Connecticut USA.
- 5National Bureau of Economic Research Cambridge Massachusetts USA.
Abstract
Introduction
Timely dementia detection is critical for care planning and supportive services, yet whether claims-based detection has improved over time remains unknown.Methods
This retrospective cohort study used Health and Retirement Study (HRS) survey data linked to Medicare claims (1998 to 2020). Persons with probable dementia (PWPD) were identified using the Langa-Weir algorithm. Covariate-adjusted logistic regression with predictive margins estimated the proportions of PWPD receiving a claims-based dementia diagnosis, overall and among early-stage PWPD.Results
Among 3144 PWPD from 2004 to 2019, fewer than half of PWPD in Traditional Medicare (TM) had ever been diagnosed, with no significant improvement. Annual detection from 2015 to 2019 was consistently higher in TM than in Medicare Advantage (MA), with adjusted proportions rising from 36.7% versus 32.1% to 48.8% versus 39.2%, but remained low and unchanged among early-stage PWPD. Detection was highest in the Northeast and lowest in the West in both TM (50.0% vs 39.5%) and MA (39.8% vs 25.7%).Discussion
Detection of dementia among PWPD remained incomplete and largely unchanged, particularly at the early stage when diagnosis is most actionable. These persistent gaps underscore the urgent need for targeted strategies to improve dementia identification across plan types and regions.
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BibTeX
@article{qian2026trends,
title = {{Trends in detection of dementia among beneficiaries in Medicare advantage and traditional Medicare.}},
author = {Yuting Qian and Heather Allore and Xi Chen},
journal = {Alzheimer's \& dementia (Amsterdam, Netherlands)},
year = {2026},
month = oct,
doi = {10.1002/dad2.70503},
url = {https://europepmc.org/article/MED/42923120},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Trends in detection of dementia among beneficiaries in Medicare advantage and traditional Medicare.
AU - Yuting Qian
AU - Heather Allore
AU - Xi Chen
PY - 2026
DA - 2026/10/21
JO - Alzheimer's & dementia (Amsterdam, Netherlands)
DO - 10.1002/dad2.70503
UR - https://europepmc.org/article/MED/42923120
AB - Introduction Timely dementia detection is critical for care planning and supportive services, yet whether claims-based detection has improved over time remains unknown.Methods This retrospective cohort study used Health and Retirement Study (HRS) survey data linked to Medicare claims (1998 to 2020). Persons with probable dementia (PWPD) were identified using the Langa-Weir algorithm. Covariate-adjusted logistic regression with predictive margins estimated the proportions of PWPD receiving a claims-based dementia diagnosis, overall and among early-stage PWPD.Results Among 3144 PWPD from 2004 to 2019, fewer than half of PWPD in Traditional Medicare (TM) had ever been diagnosed, with no significant improvement. Annual detection from 2015 to 2019 was consistently higher in TM than in Medicare Advantage (MA), with adjusted proportions rising from 36.7% versus 32.1% to 48.8% versus 39.2%, but remained low and unchanged among early-stage PWPD. Detection was highest in the Northeast and lowest in the West in both TM (50.0% vs 39.5%) and MA (39.8% vs 25.7%).Discussion Detection of dementia among PWPD remained incomplete and largely unchanged, particularly at the early stage when diagnosis is most actionable. These persistent gaps underscore the urgent need for targeted strategies to improve dementia identification across plan types and regions.
SN - 2352-8729
ER -