{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:56:34Z","timestamp":1790675794247,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"South Carolina SmartState Endowed Center for Environmental and Biomedical Panomics"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neuropsychiatric symptoms (NPS) are common and clinically consequential in Alzheimer's disease and related dementias (ADRD), yet their recognition and treatment may vary across socioeconomic groups. Dual-eligible Medicare\u2013Medicaid beneficiaries represent a vulnerable population, but differences in NPS documentation and management remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether dual eligibility is associated with differences in (1) documented NPS and (2) prescription fills among Medicare beneficiaries with ADRD who received home health (HH) care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study of 167,484 Medicare Part D beneficiaries with ADRD who received HH care and were identified using the Chronic Conditions Warehouse flag. Dual eligibility was the primary exposure. NPS were identified using diagnosis codes from medical claims. Prescription fills for NPS-related medications were identified using Medicare Part D prescription drug event data (\u22652 prescription fills for anxiety-related medications and antidepressants). Logistic regression models estimated associations of dual eligibility with NPS documentation and prescription fills, adjusting for demographic characteristics, original Medicare entitlement, and comorbidity burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Dual-eligible beneficiaries comprised 30.7% of the cohort. Documented confusion and anxiety were the most prevalent symptoms. Dual-eligible beneficiaries had a higher prevalence of confusion (83.5% versus 82.0%) and anxiety (57.0% versus 53.2%) compared with Medicare-only beneficiaries. After adjustment, dual eligibility was associated with higher odds of documented confusion (aOR 1.18, 95% CI 1.14\u20131.22) and anxiety (aOR 1.19, 95% CI 1.15\u20131.22). Dual eligibility was also associated with slightly higher odds of anxiety-related prescription fills (aOR 1.21, 95% CI 1.17\u20131.26), whereas antidepressant prescription fills did not differ (aOR 1.00, 95% CI 0.95\u20131.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dual eligibility was associated with modest differences in NPS documentation and prescription fills, suggesting differences in recognition and management of NPS among beneficiaries with ADRD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261478140","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T06:48:12Z","timestamp":1787381292000},"page":"1449-1457","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual eligibility and neuropsychiatric symptoms and treatment disparities among Medicare Part D beneficiaries with Alzheimer's disease and related dementias"],"prefix":"10.1177","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0499-8283","authenticated-orcid":false,"given":"Sara","family":"Alsharayri","sequence":"first","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5070-7117","authenticated-orcid":false,"given":"Sara","family":"Knox","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3915-4939","authenticated-orcid":false,"given":"Maxwell","family":"Cutty","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-0698","authenticated-orcid":false,"given":"Abe","family":"Mollalo","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"2025 Alzheimer\u2019s disease facts and figures","volume":"21","author":"Alzheimer\u2019s Association","year":"2025","unstructured":"Alzheimer\u2019s Association. 2025 Alzheimer\u2019s disease facts and figures. Alzheimers Dement 2025; 21: e70235.","journal-title":"Alzheimers Dement"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2007.04.381"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.05.2410"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1858"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.12.2308"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12730"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03314.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1594"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-240004"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2024.10.3855"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"e_1_3_3_13_2","volume-title":"Chronic disease and co-morbidity among dual eligibles: Implications for patterns of Medicaid and Medicare service use and spending. Report no. Publication #8081","author":"Kasper J","year":"2010","unstructured":"Kasper J, O'Malley Watts M, Lyons B. Chronic disease and co-morbidity among dual eligibles: Implications for patterns of Medicaid and Medicare service use and spending. Report no. Publication #8081. Kaiser Commission on Medicaid and the Uninsured, 2010."},{"key":"e_1_3_3_14_2","first-page":"63","article-title":"Managed care and dually eligible beneficiaries: challenges in coordination","volume":"24","author":"Walsh EG","year":"2002","unstructured":"Walsh EG, Clark WD. Managed care and dually eligible beneficiaries: challenges in coordination. Health Care Financ Rev 2002; 24: 63.","journal-title":"Health Care Financ Rev"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15082"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1021"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-026-07031-7"},{"key":"e_1_3_3_18_2","unstructured":"Medicaid and CHIP Payment and Access Commission. Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid https:\/\/www.macpac.gov\/wp-content\/uploads\/2024\/01\/Jan24_MedPAC_MACPAC_DualsDataBook-508.pdf (2024)."},{"key":"e_1_3_3_19_2","unstructured":"Kaiser Family Foundation. A profile of Medicare-Medicaid enrollees (dual eligibles) https:\/\/www.kff.org\/medicare\/a-profile-of-medicare-medicaid-enrollees-dual-eligibles\/ (2023)."},{"key":"e_1_3_3_20_2","unstructured":"Centers for Medicare & Medicaid Services. Chronic Conditions Data Warehouse (CCW): Condition Categories \u2013 27 Chronic Conditions https:\/\/www2.ccwdata.org\/web\/guest\/condition-categories-chronic (2024 accessed 2026 May 28)."},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e3182051a9b"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h369"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2009-1099"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4377-y"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2012.03905.x"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.36918"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2004.52054.x"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.3018"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.211266"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1512532"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb04580.x"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1230"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261478140","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877261478140","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261478140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:07:39Z","timestamp":1790672859000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877261478140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/13872877261478140"],"URL":"https:\/\/doi.org\/10.1177\/13872877261478140","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]}}}