Cognitive Impairment at Initial Diagnosis of Alzheimer’s Disease: Patient Characteristics and Treatments in the Real-World Setting
Author(s)
Amanda Grace Althoff, MS, Lawrence Rasouliyan, MPH.
OMNY Health, Atlanta, GA, USA.
OMNY Health, Atlanta, GA, USA.
Presentation Documents
OBJECTIVES: The objective of this research was to characterize Alzheimer’s disease (AD) patients based on cognitive impairment at initial diagnosis and describe initial treatments in the real-world setting.
METHODS: Electronic health records from 5 integrated delivery networks within the OMNY Health real-world data platform from 2017 to 2024 were accessed. Patients were included if they ever had a diagnosis code for AD and had a score recorded for either the Montreal Cognitive Assessment (MOCA) or Mini Mental State Exam (MMSE) within 30 days of their index AD diagnosis. Severity categorizations were based on the MOCA/MMSE scores. Demographics were tabulated at the AD index and treatments at index were required to be within 30 days.
RESULTS: Of the nearly 150,000 AD patients, 6,973 had a score for MOCA or MMSE in the time window of the index AD diagnosis. The distribution across the cognitive severity categories was found to be 15% normal, 37% mild, 35% moderate, and 13% severe. The distribution of gender became more female predominant with increasing cognitive impairment severity (51%, 60%, 64%, and 67%, respectively). The moderate and severe groups had slightly higher percentages of nonwhite patients compared to normal and mild (22%/27% versus 15%/17%). Distributions of age (mean: 78 years) and ethnicity (96% not Hispanic or Latino) were similar between the severity categories. Across all patients, 59% were being treated with cholinesterase inhibitors or N-methyl-D-aspartate receptor inhibitors at index, with similar usage across severity groups (56%, 61%, 60%, 56%, respectively). Of these patients, 65% had no prior treatment. Less than 1% of patients were treated with monoclonal antibodies at index.
CONCLUSIONS: Early diagnosis and treatment are important in managing AD. Results provide a descriptive insight into cognitive impairment at initial AD diagnosis. As newly approved drugs are used more, future analyses comparing treatment strategies across cognitive impairment categories could be beneficial.
METHODS: Electronic health records from 5 integrated delivery networks within the OMNY Health real-world data platform from 2017 to 2024 were accessed. Patients were included if they ever had a diagnosis code for AD and had a score recorded for either the Montreal Cognitive Assessment (MOCA) or Mini Mental State Exam (MMSE) within 30 days of their index AD diagnosis. Severity categorizations were based on the MOCA/MMSE scores. Demographics were tabulated at the AD index and treatments at index were required to be within 30 days.
RESULTS: Of the nearly 150,000 AD patients, 6,973 had a score for MOCA or MMSE in the time window of the index AD diagnosis. The distribution across the cognitive severity categories was found to be 15% normal, 37% mild, 35% moderate, and 13% severe. The distribution of gender became more female predominant with increasing cognitive impairment severity (51%, 60%, 64%, and 67%, respectively). The moderate and severe groups had slightly higher percentages of nonwhite patients compared to normal and mild (22%/27% versus 15%/17%). Distributions of age (mean: 78 years) and ethnicity (96% not Hispanic or Latino) were similar between the severity categories. Across all patients, 59% were being treated with cholinesterase inhibitors or N-methyl-D-aspartate receptor inhibitors at index, with similar usage across severity groups (56%, 61%, 60%, 56%, respectively). Of these patients, 65% had no prior treatment. Less than 1% of patients were treated with monoclonal antibodies at index.
CONCLUSIONS: Early diagnosis and treatment are important in managing AD. Results provide a descriptive insight into cognitive impairment at initial AD diagnosis. As newly approved drugs are used more, future analyses comparing treatment strategies across cognitive impairment categories could be beneficial.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD2
Topic
Health Service Delivery & Process of Care
Disease
SDC: Neurological Disorders