Assessing Dementia: An Analysis of Cognitive Scores, Pharmacy Costs, and Medication Adherence Using Unstructured and Structured Data

OBJECTIVES: Dementia, associated with various cognitive deficiencies, disrupts daily life. In 2022, dementia care's annual cost exceeded $300 billion, burdening healthcare systems, families, and caregivers. Our study employs Cognitive Assessment Tools (CAT) for identifying dementia patients and investigates the medical cost, disease specific pharmacy cost and adherence based on cognitive impairment severity.

METHODS: We used ICD10 diagnosis codes to identify dementia patients aged 65+ in 2018 from the Optum de-identified Market Clarity Database. The inclusion criteria were either two outpatient or one inpatient confirmed diagnosis. The first recorded dementia diagnosis was considered as the index event. We ensured 12-month medical and pharmacy eligibility pre- and post-index. CAT (MMSE, MOCA, SLUMS) mentions and their scores in structured and unstructured data helped categorize dementia severity. We observed dementia-specific standard medical costs for 12 months.

RESULTS: Out of 101,126 patients, CAT scores were found in 3% and 9% of structured and unstructured data, respectively. Among these, normal, mild, moderate, and severe CAT scores were seen in 24%, 21%, 32%, and 23% of patients, respectively. A gender-based analysis showed differences in mild and severe CAT scores between females and males.

CONCLUSIONS: Our study underscores CAT's importance in dementia diagnosis. Early detection and interventions can mitigate disease and economic impact on healthcare systems, caregivers, and society. The findings can assist in policymaking and healthcare planning, enabling better resource allocation for dementia care based on cognitive impairment.