Guneet Jasuja, United States of America
Bedford VA Healthcare System Center for Healthcare Organization and Implementation ResearchAuthor Of 1 Presentation
EPIDEMIOLOGY OF MILD COGNITIVE IMPAIRMENT, ALZHEIMER’S DISEASE, AND RELATED DEMENTIA IN U.S. VETERAN PATIENTS
Abstract
Aims
Alzheimer’s disease (AD) is a progressively debilitating, neurodegenerative disorder. We report on the epidemiology of mild cognitive impairment (MCI), AD, and AD Related Dementia (ADRD) using electronic health records (EHR) over the past 20 years from the U.S. Veterans Affairs health care system (VA).
Methods
Incident and prevalent cases were identified from outpatient, inpatient, and extended care EHR for all Veterans aged 50 years and older in VA care from 2000-2019 based on ≥2 days with relevant ICD-9/10-CM codes. Alternative criteria were explored. Estimates of annual prevalence and incidence rates were age- and sex-standardized to the 2010 U.S. Census general population. Poisson regression was used to evaluate trends.
Results
A total of 176,674 veterans with MCI, 294,617 with AD, and 450,199 with ADRD were identified. Standardized MCI rates increased steeply, with prevalence of less than 0.09% before 2007, increasing to 1.16% in 2019. Standardized AD prevalence decreased from 0.65% in 2000 to 0.41% in 2019, with similar declines in incidence from 0.26% to 0.08%. Standardized ADRD prevalence declined from 1.97% in 2000 to 0.75% in 2007 and then increased to 1.05% in 2019, with most of the increase in the category of dementia not-otherwise-specified. ADRD Incidence was similar from 0.42% in 2002 decreasing to 0.23% in 2007 then increasing to 0.31% in 2019. For all three conditions, rates increased steeply with age, and were higher in women and African Americans.
Conclusions
We observed recent trends of declining clinical identification of AD but increasing MCI and ADRD.