TIME COURSE OF PRECURSOR NON-COGNITIVE CONDITIONS 5 YEARS PRIOR TO ALZHEIMER'S DISEASE DEMENTIA DIAGNOSIS
Author(s)
Abbass IM1, DeClue R2, Choi D1, Seleri S1, Ruble M2, van Amerongen D3, Wallick C1, Suehs B2
1Genentech, Inc., South San Francisco, CA, USA, 2Humana Inc., Louisville, KY, USA, 3Humana of Ohio, Cincinnati, OH, USA
OBJECTIVES : Alzheimer’s disease (AD) is part of a continuum, starting with brain pathology in cognitively normal individuals, followed by an extended prodromal period characterized by a progressive decline in cognitive function. Most research characterizing comorbidities preceding AD-dementia diagnosis focuses on cognitive conditions and is generally limited to the 2 years pre-diagnosis. In this analysis, we investigate trends in the prevalence of non-cognitive conditions over the 5-year period prior to AD-dementia diagnosis. METHODS : Individuals enrolled in a Medicare Advantage Prescription Drug plan and newly diagnosed with AD-dementia between 01/01/2012 and 06/30/2018 were identified and matched on pre-cohort entry characteristics to clinically similar individuals who did not develop AD or a related dementia. Non-cognitive conditions were defined using the AHRQ CCS condition categories. Annual prevalence of non-cognitive conditions in AD dementia and non-AD cohorts was determined for each of the 5 years pre-diagnosis and the overall pre-diagnosis period, and the prevalence ratio (PR) was calculated. RESULTS : In total, 27,308 individuals were matched and included in each group. Cerebrovascular diseases, falls, syncope, acute renal failure, and injuries had the greatest PR during the pre-diagnosis period. PR of these conditions increased over each year during the 5-year pre-diagnosis period. Conditions with the greatest PR during the year immediately prior to diagnosis of AD were: cerebrovascular conditions (7.4); acute cerebrovascular disease (4.8); falls (4.0); transient cerebral ischemia (3.9); syncope (3.5); acute and unspecified renal failure (2.9); open wounds of head, neck, or trunk (2.7); and other injuries and conditions due to external causes (2.7). CONCLUSIONS : This study documented non-cognitive conditions preceding AD-dementia diagnosis, notably cerebrovascular diseases, injuries, and kidney (renal) failure. This work seeks to inform understanding of the non-cognitive conditions preceding AD-dementia diagnosis and identify early signals that can be used to build predictive models and guide early diagnosis and intervention.
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PND61
Topic
Epidemiology & Public Health
Disease
Neurological Disorders