Over 47% of older adults die with a diagnosis of dementia on their records, up by 36% from 2004. The corresponding study was published in JAMA.
In recent years, conditions such as Alzheimer's disease (ADRD) and related dementias have received increasing attention from clinicians, researchers, policymakers, and the public. However, despite the increased levels of awareness, until now, few studies have tracked changes in the documentation of dementia diagnoses.
For the current study, researchers analyzed cross-sectional data from 3, 515 329 people in the U.S. aged 67 years or older who died between 2004 and 2017. Diagnosis codes on bills submitted by providers to the traditional Medicare system were used to identify diagnoses of ADRD in the last two years of life.
After analyzing the data, the researchers found that while in 2004, around 35% of people were diagnosed with dementia in the last two years of their life, this figure rose to over 47% in 2017. They further found that in 2017, 39% of patients had at least two medical claims mentioning dementia, up from 25% in 2004.
The researchers also noted that end-of-life care for patients with dementia changed significantly. Whereas 36% received hospice care in 2004, 63% did so in 2017. The authors note that this is in line with national trends increasing hospice care in the late 2010's.
"This shows we have far to go in addressing end-of-life care preferences proactively with those who are recently diagnosed, and their families," said Julie Bynum, M.D., Ph.D., senior author of the study and a professor of geriatric medicine at Michigan Medicine.
"Where once the concern may have been underdiagnosis, now we can focus on how we use dementia diagnosis rates in everything from national budget planning to adjusting how Medicare reimburses Medicare Advantage plans," she added.