Developing and Evaluating a Surveillance System for Alzheimer's Dementia In the United States

在美国开发和评估阿尔茨海默氏痴呆症监测系统

• 批准号: 10369902
• 负责人: David B Rein
• 金额: $ 56.09万
• 依托单位: NATIONAL OPINION RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10369902
• 关键词: Address; Adult; Advocacy; Affect; Age; Algorithms; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; American; COVID-19 impact; COVID-19 mortality; Caring; Characteristics; Code; Cognition; Cognitive; Communities; County; Data; Data Analyses; Dementia; Diagnosis; Diagnostic; Diagnostic Services; Eligibility Determination; Ethnic Origin; Evaluation; General Population; Geography; Goals; Government; Health; Health and Retirement Study; Information Systems; Link; Long-Term Care; Low Income Population; Measures; Medicaid; Medical; Medicare; Medicare claim; Medicare/Medicaid; Methodology; Monitor; National Institute on Aging; Nongovernmental Organizations; Outcome; Patients; Persons; Population; Predictive Value; Prevalence; Public Advocacies; Public Health; Race; Research; Research Design; Research Personnel; Resources; Retirement; Sensitivity and Specificity; Services; Sexual and Gender Minorities; Source; Stratification Factors; Surveys; System; Time; United States; Update; Work; age group; beneficiary; care systems; comorbidity; cost; data infrastructure; diagnostic value; ethnic minority; fight against; health disparity; human old age (65+); improved; innovation; mortality; payment; prevent; racial minority; rural dwellers; service utilization; sex; sociodemographics; validation studies; web site

PROJECT SUMMARY/ABSTRACT Alzheimer's disease and related dementias (ADRD) affect as many as 5.7 million Americans and will cost the U.S. economy between $379 and $500 billion per year by 2040. Goal 5 of the 2020 update to the National Plan to Address Alzheimer's, "Improve data to track progress", recognizes the need for increased surveillance of ADRD. The goal states, "Data and surveillance efforts are paramount to tracking the burden of ADRD … and assist with understanding health disparities among populations such as racial and ethnic minorities, low- income populations, rural residents, and sexual and gender minorities." No data or surveillance system currently exists for ADRD surveillance. However, Medicare and Medicaid data offer a promising source of information to track ADRD diagnoses. Medicare covers most Americans over the age of 65, and Medicaid covers long-term care services for people with ADRD. In 2016, the Data Infrastructure Committee of the National Institute on Aging (NIA) identified "ways to reduce the significant obstacles faced by researchers in using medical care claims and encounter data" as a primary NIA objective, highlighting the importance and value of Medicare and Medicaid data. We propose to create a publicly accessible system to (1) track ADRD diagnoses in Medicare and Medicaid; (2) conduct research to understand the correlation between diagnosed and assessed dementia; and (3) demonstrate the value of the new system by using its data to evaluate an important research question. In Aim 1, we propose to leverage an established set of partners and methodologies to develop a publicly accessible system to monitor and surveil ADRD diagnoses in Medicare and Medicaid, providing information at the national, state and county level and by age, sex, race/ethnicity, comorbidity, eligibility and other characteristics and stratification factors. Medical claims do not identify all persons living with dementia, so additional research is needed to understand the biases embedded in payment claims information. In Aim 2, we will evaluate the predictive power of Medicare claims in identifying persons with assessed dementia using linked data from Medicare and the nationally representative Health and Retirement Study (HRS). Aim 2 will estimate the sensitivity and specificity of Medicare claims in detecting HRS assessed dementia and explore differences across sociodemographic, health, and cognitive factors. Finally, in Aim 3, we propose to use the new surveillance platform to perform a demonstration analysis; estimating rates of COVID-19 mortality among patients diagnosed with ADRD in Medicare. When completed, the system we describe will provide a much-needed ADRD surveillance system, vastly expanding access to and understanding of Medicare and Medicaid ADRD information for the research community and general public.

项目摘要/摘要 阿尔茨海默氏病和相关痴呆症（ADRD）影响多达570万美国人，将使 到2040年，美国经济每年在379美元至5000亿美元之间。2020年更新的目标5 为了解决阿尔茨海默氏症的“改进数据以跟踪进度”，认识到需要增加监视的需求 adrd。目标指出：“数据和监视工作对于跟踪ADRD的燃烧至关重要…… 协助了解种族和少数民族等人群之间的健康差异，低 - 收入人口，粗糙的居民以及性别和性别少数群体。“没有数据或监视系统 目前存在用于ADRD监视。但是，Medicare和Medicaid数据提供了有望的来源 信息以跟踪ADRD诊断。 Medicare覆盖了65岁以上的大多数美国人，Medicaid 为ADRD患者提供长期护理服务。 2016年，数据基础设施委员会 美国国家老化研究所（NIA）确定了“减少研究人员在 使用医疗索赔和遇到数据“作为主要的NIA目标，强调了重要性和 医疗保险和医疗补助数据的价值。我们建议创建一个可公开访问的系统到（1）跟踪ADRD Medicare和Medicaid的诊断； （2）进行研究以了解诊断之间的相关性 并评估痴呆症； （3）通过使用其数据评估新系统的价值 重要的研究问题。在AIM 1中，我们建议利用一组既定的合作伙伴以及 开发公共访问系统以监视和调查Medicare中的ADRD诊断的方法 和医疗补助，在国家，州和县一级提供信息，以及年龄，性别，种族/种族， 合并症，资格和其他特征和分层因素。医疗索赔并未确定所有 患有痴呆症的人，因此需要进行其他研究以了解付款中嵌入的偏见 要求信息。在AIM 2中，我们将评估Medicare主张在识别人方面的预测能力 使用Medicare和全国代表性健康的链接数据进行评估的痴呆症以及 退休研究（HRS）。 AIM 2将估计Medicare主张在检测HRS时的敏感性和特异性 评估痴呆症并探索社会人口统计学，健康和认知因素之间的差异。最后，在 AIM 3，我们建议使用新的监视平台进行演示分析；估计率 在医疗保险中被诊断为ADRD的患者中的COVID-19死亡率。完成后，系统 描述将提供急需的ADRD监视系统，大大扩展了对和 了解研究社区和公众的医疗保险和医疗补助信息。