OBJECTIVES: Recent studies highlight prevalent anti-dementia drug treatment in patients without a documented dementia diagnosis. We aimed to compare characteristics of a treated-only population with those diagnosed and treated, and matched controls without diagnosis or treatment.

METHODS: We extracted data on adult beneficiaries, newly diagnosed with dementia and/or receiving dementia treatment between 2011 and 2014 with 36 months’ continuous medical/prescription coverage before first diagnosis and/or treatment and 6 months’ follow-up from the OptumLabs™ Data Warehouse. We characterized demographics, comorbidities and anti-dementia drug use among treated-only, diagnosed and treated, and matched controls. We examined characteristics in the 3 months pre- and post- first anti-dementia drug fill among treated-only individuals, by healthcare setting.

RESULTS: We identified 4,732 treated-only, 8,850 diagnosed and treated, and 95,464 matched control individuals. Compared to diagnosed and treated, and matched controls, treated-only individuals were younger [Mean age(sd) = 75(11) vs 79(07) and 79(11) respectively]; privately-insured (30% vs 22%, 33%); prescribed an anti-dementia by a general practitioner (33% vs 27%, 0%). Treated-only individuals had more prevalent obstructive sleep apnea (15% vs 12%) and single use of donepezil (68% vs 66%) or memantine (14% vs 10%) compared to diagnosed and treated individuals. Among treated-only individuals, diagnosis codes with probable relation to dementia symptomology around a first anti-dementia drug fill included memory loss (46%), malaise and fatigue (21%), organic brain syndrome (13%), depressive disorder (11%), dizziness and giddiness (10%), and anxiety state (7.5%). Forty-one percent of treated-only individuals averaged 2 ‘memory loss’ diagnosis codes prior to first anti-dementia drug fill with 84% of memory loss codes occurring in an outpatient setting.

CONCLUSIONS: Some demographic and symptomology differences exist between patients receiving anti-dementia drugs without a corresponding dementia diagnosis and those with a dementia diagnosis and treatment. These differences may provide insights that may inform future studies in dementia and its treatment, using claims data.