Executive function, episodic memory, and Medicare expenditures.
Executive function, episodic memory, and Medicare expenditures.
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DOI：
10.1016/j.jalz.2016.12.013
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发表时间：
2017-07
期刊：
影响因子：
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通讯作者：
Bynum JPW
中科院分区：
文献类型：
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作者：
Bender AC;Austin AM;Grodstein F;Bynum JPW
我们研究了医疗保健支出和认知之间的关系，重点关注由整体认知，执行功能或情景记忆定义的认知系统之间的差异。我们使用线性回归模型比较了8，125名护士健康研究参与者的认知状态的年度健康支出，这些参与者完成了认知电池并参加了Medicare A和B部分。经人口统计学和合并症调整后，与无损伤的人相比，执行功能障碍与每人1，488美元的较高年度总支出相关（p<0.01）。支出与执行功能呈线性关系，但与情景记忆无关（执行功能每降低1个标准差，支出增加584美元; p<0.01）。执行功能的损害与较高的医疗支出具体和线性相关。注重解决执行功能早期丧失的管理战略，可能会有效地减少昂贵的服务。
We examined the relationship between healthcare expenditures and cognition, focusing on differences across cognitive systems defined by global cognition, executive function, or episodic memory. We used linear regression models to compare annual health expenditures by cognitive status in 8,125 Nurses’ Health Study participants who completed a cognitive battery and were enrolled in Medicare parts A and B. Adjusting for demographics and comorbidity, executive impairment was associated with higher total annual expenditures of $1,488 per person (p<.01) compared to those without impairment. No association for episodic memory impairment was found. Expenditures exhibited a linear relationship with executive function, but not episodic memory ($584 higher for every 1 standard deviation decrement in executive function; p<.01). Impairment in executive function is specifically and linearly associated with higher healthcare expenditures. Focusing on management strategies that address early losses in executive function may be effective in reducing costly services.