Gender Differences in Use of Cerebrospinal Fluid Biomarker Test and Positron Emission Tomography for Diagnosing Mild Cognitive Impairment, Alzheimer's Disease, and Other Dementias in the Real World Setting
Author(s)
Jessie T. Yan, PhD1, Zheng Wu, MS2, Marwan Noel Sabbagh, MD3, Vishakha Sharma, PhD1, Viviktha Ramesh, MD1, Sophie Roth, MSc4, Yamina Rajput, M.Sc.5.
1Roche Information Solutions, Roche Diagnostics, Santa Clara, CA, USA, 2Genesis Research Group, Hoboken, NJ, USA, 3Barrow Neurological Institute, Phoenix, AZ, USA, 4Roche Diagnostics International Ltd, Rotkreuz, Switzerland, 5Roche Diagnostics Corporation, Indianapolis, IN, USA.
1Roche Information Solutions, Roche Diagnostics, Santa Clara, CA, USA, 2Genesis Research Group, Hoboken, NJ, USA, 3Barrow Neurological Institute, Phoenix, AZ, USA, 4Roche Diagnostics International Ltd, Rotkreuz, Switzerland, 5Roche Diagnostics Corporation, Indianapolis, IN, USA.
Presentation Documents
OBJECTIVES: About 2/3 of Americans diagnosed with Alzheimer's disease (AD) or other dementias are women. However, it is unknown whether use of confirmatory tests, including cerebrospinal fluid (CSF) biomarker test, and amyloid positron emission tomography (PET) for these diseases differed by gender. The objective of the study is to compare the gender differences in use of these diagnostic tests.
METHODS: Using data from the Medicare 100% Research Identifiable files, this retrospective observational study included fee-for-service (FFS) beneficiaries ≥ 67 years old and newly diagnosed with mild cognitive impairment (MCI), AD, or other dementias between 2017 and 2020. Chi-square analyses were first conducted to compare the unadjusted gender differences in the use of CSF and PET including amyloid PET tests during the 1 year prior to or on their first MCI, AD, or other dementia diagnosis (the baseline period). Firth's penalized logistic regression analyses were then performed to adjust for baseline sociodemographic and clinical factors.
RESULTS: Of the total 412,468 patients (46,253 MCI, 115,788 AD, and 250,427 other dementias) included in the final study sample, 251,812 (61.1%) were female. Compared to women, men had higher utilizations of CSF (2.6% vs. 1.9%) and PET (1.0% vs. 0.6%) than women (all p<0.001). Adjusting for factors such as age, race/ethnicity, county of residence, physician specialty, and comorbidities, men had higher odds of receiving CSF [Odds Ratio (95% confidence interval): 1.05 (1.01-1.10), p=0.02] and PET (1.22 (1.13-1.31), p<0.0001] tests during the 1 year before the disease diagnosis.
CONCLUSIONS: In a nationally representative cohort of Medicare FFS beneficiaries, we found that women are less likely to receive CSF biomarker and PET tests to confirm their MCI, AD, or other dementia diagnosis than men.
METHODS: Using data from the Medicare 100% Research Identifiable files, this retrospective observational study included fee-for-service (FFS) beneficiaries ≥ 67 years old and newly diagnosed with mild cognitive impairment (MCI), AD, or other dementias between 2017 and 2020. Chi-square analyses were first conducted to compare the unadjusted gender differences in the use of CSF and PET including amyloid PET tests during the 1 year prior to or on their first MCI, AD, or other dementia diagnosis (the baseline period). Firth's penalized logistic regression analyses were then performed to adjust for baseline sociodemographic and clinical factors.
RESULTS: Of the total 412,468 patients (46,253 MCI, 115,788 AD, and 250,427 other dementias) included in the final study sample, 251,812 (61.1%) were female. Compared to women, men had higher utilizations of CSF (2.6% vs. 1.9%) and PET (1.0% vs. 0.6%) than women (all p<0.001). Adjusting for factors such as age, race/ethnicity, county of residence, physician specialty, and comorbidities, men had higher odds of receiving CSF [Odds Ratio (95% confidence interval): 1.05 (1.01-1.10), p=0.02] and PET (1.22 (1.13-1.31), p<0.0001] tests during the 1 year before the disease diagnosis.
CONCLUSIONS: In a nationally representative cohort of Medicare FFS beneficiaries, we found that women are less likely to receive CSF biomarker and PET tests to confirm their MCI, AD, or other dementia diagnosis than men.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR46
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
SDC: Neurological Disorders