Desai Urvi, Kirson Noam Y, Ye Wenyu, Mehta Nori R, Wen Jody, Andrews J Scott
Analysis Group, Inc., Boston, MA, USA.
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
Alzheimers Dement (Amst). 2019 Jan 25;11:125-135. doi: 10.1016/j.dadm.2018.12.005. eCollection 2019 Dec.
This study evaluates rates of all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls in 3 years preceding Alzheimer's disease (AD) diagnosis.
Patients with AD and controls with no cognitive impairment were identified from the Medicare claims data. Patients were required to be aged ≥ 65 years and have continuous Medicare enrollment for ≥4 years before the index date (AD cohort: first AD diagnosis in 2012-2014; controls: randomly selected medical claim). Outcomes for each preindex year were compared among propensity score-matched cohorts.
Each year, before index, patients with AD were more likely to have all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls ( < .05 for all comparisons) than matched controls (N = 19,679 pairs). Increasing absolute and relative risks over time were observed for all outcomes.
The study findings highlight the growing burden of illness before AD diagnosis and emphasize the need for timely recognition and management of patients with AD.
本研究评估了阿尔茨海默病（AD）诊断前3年全因急诊就诊率、全因住院率、潜在可避免住院率和跌倒发生率。
从医疗保险理赔数据中识别出AD患者和无认知障碍的对照者。患者年龄需≥65岁，且在索引日期前连续参加医疗保险≥4年（AD队列：2012 - 2014年首次AD诊断；对照：随机选择的医疗理赔）。在倾向评分匹配队列中比较每个索引前年份的结局。
在索引前的每年，AD患者比匹配的对照者更有可能进行全因急诊就诊、全因住院、潜在可避免住院和跌倒（所有比较P <.05）（N = 19,679对）。所有结局随时间的绝对和相对风险均增加。
研究结果突出了AD诊断前疾病负担的不断增加，并强调了及时识别和管理AD患者的必要性。
