{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:12:08Z","timestamp":1777396328095,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2023,1,17]]},"abstract":"<jats:p>Background: The high burden of dementia and Alzheimer\u2019s disease (AD) increases substantially as disease progresses. Characterizing early patterns of health care utilization among patients who develop cognitive impairment may deepen our understanding of early disease trajectory and potentially facilitate timely diagnosis and management. Objective: Describe clinical characteristics, healthcare utilization, and costs in early-stage dementia by disease severity and amyloid-\u03b2 status before enrollment in an observational study (GERAS-US). Methods: Consented patients\u2019 GERAS-US data were linked to available five-years of Medicare claims history before GERAS-US enrollment. Clinical characteristics, comorbidity, and pre-\/post-diagnosis healthcare use and costs were assessed. Continuous and categorical variables were compared between severity and amyloid-status cohorts using t-test and Chi-square statistics; linear regression models were used to compare cost and utilization measures after adjusting for differences in patients\u2019 observation time. Relative likelihood of observed diagnoses, comorbidity, and prescription drug use among cohorts were presented as OR and 90% confidence interval (CI). Results: Of 174 patients clinically diagnosed with early dementia (mild cognitive impairment (MCI): 101; mild dementia (MILD): 73), 55% were amyloid-positive. Memory loss was more likely in MILD versus MCI (OR:1.85, 90% CI 1.10\u20133.09) and in amyloid-positive versus amyloid-negative cohorts (OR:1.98, 90% CI 1.19\u20133.29). Mean annual healthcare costs after cognitive impairment\/dementia diagnosis were significantly higher for MILD versus MCI ($1191 versus $712, p\u200a=\u200a0.067) and amyloid-negative versus amyloid-positive ($1281 versus $701, p\u200a=\u200a0.034). Diabetes was more prevalent in MILD and amyloid-negative cohorts. Conclusion: Comorbidity and economic burden increased in earliest stages of MCI and MILD and were higher in patients who were amyloid-negative.<\/jats:p>","DOI":"10.3233\/jad-220415","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T13:10:25Z","timestamp":1670332225000},"page":"753-765","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and Economic Assessment in Early-Stage Dementia by Severity and Amyloid-\u03b2 Status: A 5-Year Retrospective Claims Study of GERAS-US Patients"],"prefix":"10.1177","volume":"91","author":[{"given":"Julie","family":"Chandler","sequence":"first","affiliation":[{"name":"Eli Lilly and Company, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Kubisiak","sequence":"additional","affiliation":[{"name":"Westat Inc., Rockville, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-220415_ref1","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1002\/alz.12328","article-title":"2021 Alzheimer\u2019s disease facts and figures","volume":"17","author":"Alzheimer\u2019s Association","year":"2021","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-220415_ref2","first-page":"1","article-title":"Mortality in the United States, 2019","author":"Kochanek","year":"2020","journal-title":"NCHS Data Brief"},{"key":"10.3233\/JAD-220415_ref3","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1001\/jama.2021.5469","article-title":"The leading causes of death in the US for 2020","volume":"325","author":"Ahmad","year":"2021","journal-title":"JAMA"},{"key":"10.3233\/JAD-220415_ref4","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1002\/alz.12362","article-title":"Population estimate of people with clinical Alzheimer\u2019s disease and mild cognitive impairment in the United States (2020-2060)","volume":"17","author":"Rajan","year":"2021","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-220415_ref5","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.jalz.2018.02.018","article-title":"NIA-AA Research Framework: Toward a biological definition of Alzheimer\u2019s disease","volume":"14","author":"Jack","year":"2018","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-220415_ref6","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1093\/brain\/awv029","article-title":"Prevalence and prognosis of Alzheimer\u2019s disease at themild cognitive impairment stage","volume":"138","author":"Vos","year":"2015","journal-title":"Brain"},{"key":"10.3233\/JAD-220415_ref7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13024-019-0333-5","article-title":"The neuropathological diagnosis of Alzheimer\u2019s disease","volume":"14","author":"DeTure","year":"2019","journal-title":"Mol Neurodegener"},{"key":"10.3233\/JAD-220415_ref8","doi-asserted-by":"crossref","first-page":"101859","DOI":"10.1016\/j.nicl.2019.101859","article-title":"Diagnosis and prognosis of Alzheimer\u2019s disease using brain morphometry and white matter connectomes","volume":"23","author":"Wang","year":"2019","journal-title":"Neuroimage Clin"},{"key":"10.3233\/JAD-220415_ref9","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1002\/alz.12480","article-title":"Contribution of Alzheimer\u2019s biomarkers and risk factors to cognitive impairment and decline across the Alzheimer\u2019s disease continuum","volume":"18","author":"Tosun","year":"2021","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-220415_ref10","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/msj.20157","article-title":"Neuropathology of Alzheimer\u2019s disease","volume":"77","author":"Perl","year":"2010","journal-title":"Mt Sinai J Med"},{"key":"10.3233\/JAD-220415_ref11","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1056\/NEJMoa1202753","article-title":"Clinical and biomarker changes in dominantly inherited Alzheimer\u2019s disease","volume":"367","author":"Bateman","year":"2012","journal-title":"N Engl J Med"},{"key":"10.3233\/JAD-220415_ref12","first-page":"123","article-title":"Alzheimer\u2019s disease - 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