Incidence of Intracerebral Hemorrhage in Patients With Mild Cognitive Impairment or Alzheimer’s Dementia Among United States Medicare Beneficiaries
Author(s)
Haixin Zhang1, Babak Haji, Phd2, Ran Gao, Phd3, Quan Zhang, MA, MEd, MPhil, MS, PhD3, Amir Abbas Tahami Monfared, Phd4.
1Director, Eisai, mahwah, NJ, USA, 2Eisai, brooklyn, NY, USA, 3Eisai, Nutley, NJ, USA, 4Eisai Inc., Nutley, NJ, USA.
1Director, Eisai, mahwah, NJ, USA, 2Eisai, brooklyn, NY, USA, 3Eisai, Nutley, NJ, USA, 4Eisai Inc., Nutley, NJ, USA.
OBJECTIVES: This study evaluated the incidence of acute intracerebral hemorrhage (ICH) events inpatients with mild cognitive impairment (MCI) or Alzheimer’s dementia (AD) among United StatesMedicare Beneficiaries.
METHODS: Patients with MCI or AD were identified from fee-for-service (FFS) and Medicare Advantage(MA) databases (2016-2022) and matched 1:1 to patients without MCI/AD by age, sex, and date of firstMCI/AD ICD-10 coding. Acute ICH incidence was defined by principal inpatient ICD-10 coding for ICH(I61.0-I61.9, I60.8, I60.9). ICH subtypes were defined as cerebral amyloid angiopathy (CAA),hypertensive (HTN) and nonspecific (NS) ICH according to clinician-postulated causal mechanisms.
RESULTS: Patients with MCI (n=3,403,873) or AD (n=2,974,848) were identified. For MCI vs AD, mean agewas 78.7±8.1 vs 83.0±8.1 years, with 58% vs 63% female, 81.6% vs 80.8% White, 10.3% vs 10.6% Black,and 2.6% vs 3.3% Hispanic. Across all groups, <5% lived in rural areas. The most frequent comorbiditiesfor patients with MCI, AD, vs the comparison group were hypertension (70%, 71% vs 54%),hyperlipidemia (61%, 56% vs 46%), and diabetes (31%, 31% vs 24%). Overall ICH incidence rates were1.6, 1.8, vs 1.0 events/1000-patient years for MCI, AD vs comparison group. Combining all patientgroups, the ICH incidence rates in FFS vs MA were 1.5 vs 1.3 events/1000-patient years (odds ratio=1.16;P<0.01). The incidence events/1000-patient years for CAA-, HTN-, and NS-ICH subtypes were 0.79, 0.15,and 0.75, respectively for MCI; 0.86, 0.15, 0.86 for AD; and 0.49, 0.11, and 0.51 for the comparisongroup. Increased risk of overall ICH events was associated with advanced age, cerebrovascular disease,hypertension, diabetes, seizure, and a composite bleeding disorders variable.
CONCLUSIONS: This natural history study observed higher ICH events in AD relative to MCI or the matchedcomparison group in US Medicare. Event rates were 16% higher in FFS vs MA beneficiaries.
METHODS: Patients with MCI or AD were identified from fee-for-service (FFS) and Medicare Advantage(MA) databases (2016-2022) and matched 1:1 to patients without MCI/AD by age, sex, and date of firstMCI/AD ICD-10 coding. Acute ICH incidence was defined by principal inpatient ICD-10 coding for ICH(I61.0-I61.9, I60.8, I60.9). ICH subtypes were defined as cerebral amyloid angiopathy (CAA),hypertensive (HTN) and nonspecific (NS) ICH according to clinician-postulated causal mechanisms.
RESULTS: Patients with MCI (n=3,403,873) or AD (n=2,974,848) were identified. For MCI vs AD, mean agewas 78.7±8.1 vs 83.0±8.1 years, with 58% vs 63% female, 81.6% vs 80.8% White, 10.3% vs 10.6% Black,and 2.6% vs 3.3% Hispanic. Across all groups, <5% lived in rural areas. The most frequent comorbiditiesfor patients with MCI, AD, vs the comparison group were hypertension (70%, 71% vs 54%),hyperlipidemia (61%, 56% vs 46%), and diabetes (31%, 31% vs 24%). Overall ICH incidence rates were1.6, 1.8, vs 1.0 events/1000-patient years for MCI, AD vs comparison group. Combining all patientgroups, the ICH incidence rates in FFS vs MA were 1.5 vs 1.3 events/1000-patient years (odds ratio=1.16;P<0.01). The incidence events/1000-patient years for CAA-, HTN-, and NS-ICH subtypes were 0.79, 0.15,and 0.75, respectively for MCI; 0.86, 0.15, 0.86 for AD; and 0.49, 0.11, and 0.51 for the comparisongroup. Increased risk of overall ICH events was associated with advanced age, cerebrovascular disease,hypertension, diabetes, seizure, and a composite bleeding disorders variable.
CONCLUSIONS: This natural history study observed higher ICH events in AD relative to MCI or the matchedcomparison group in US Medicare. Event rates were 16% higher in FFS vs MA beneficiaries.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH142
Topic
Epidemiology & Public Health, Methodological & Statistical Research, Real World Data & Information Systems
Disease
Neurological Disorders