{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:44:44Z","timestamp":1791618284664,"version":"4.3.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T00:00:00Z","timestamp":1696032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG79226"],"award-info":[{"award-number":["R01AG79226"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG072559"],"award-info":[{"award-number":["R01AG072559"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG10161"],"award-info":[{"award-number":["P30AG10161"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG72975"],"award-info":[{"award-number":["P30AG72975"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG17917"],"award-info":[{"award-number":["R01AG17917"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["RF1AG22018"],"award-info":[{"award-number":["RF1AG22018"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG062711"],"award-info":[{"award-number":["R01AG062711"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01AG019783"],"award-info":[{"award-number":["P01AG019783"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Evidence indicates the health care system disproportionately misses dementia in African American compared to White individuals. In preliminary data, we examined factors related to dementia identification by the health care system among African Americans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We leveraged linked Medicare fee-for-service claims and detailed annual cohort evaluations in African Americans from 4 cohorts at Rush Alzheimer\u2019s Disease Center.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 88 African Americans with cognitive impairment (mean\u2005=\u200510 years follow-up), Medicare claims identified dementia &amp;lt;2 years from cohort diagnosis in 55%; 27% were identified 2\u20139.9 years after cohort diagnosis, and in 18% there was either no claims diagnosis during the study period, or claims identified dementia 10+ years after cohort diagnosis. Claims identification of dementia was related to older age at cohort diagnosis (eg, &amp;lt;2 years between cohort and claims: mean\u2005=\u200582 years; 10+ years\/no diagnosis: mean\u2005=\u200577 years, p\u2005=\u2005.04), lower Mini-Mental State Examination (MMSE) score (&amp;lt;2 years: mean\u2005=\u200524; 10+ years\/no diagnosis: mean\u2005=\u200526, p\u2005=\u2005.04), more depressive symptoms (&amp;lt;2 years: mean\u2005=\u20052.1 symptoms; 10+ years\/no diagnosis: mean\u2005=\u20051.2, p\u2005=\u2005.04), and more comorbidity (&amp;lt;2 years: mean\u2005=\u20055.6 comorbidities; 10+ years\/no diagnosis, mean\u2005=\u20053.0, p\u2005=\u2005.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among African Americans, preliminary data indicate the health care system most rapidly identifies dementia in older individuals, with worse cognitive and physical health. The health care system may miss opportunities for early support of African Americans with dementia, and caregivers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gerona\/glad235","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:51:18Z","timestamp":1696063878000},"source":"Crossref","is-referenced-by-count":11,"title":["Identification of Dementia in Medicare Claims Compared to Rigorous Clinical Assessments in African Americans"],"prefix":"10.1093","volume":"79","author":[{"given":"Francine","family":"Grodstein","sequence":"first","affiliation":[{"name":"Rush Alzheimer\u2019s Disease Center , Chicago, Illinois , USA"},{"name":"Department of Internal Medicine, Rush University Medical Center , Chicago, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan D","family":"James","sequence":"additional","affiliation":[{"name":"Rush Alzheimer\u2019s Disease Center , Chicago, Illinois , USA"},{"name":"Department of 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