{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:15:03Z","timestamp":1780391703929,"version":"3.54.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"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":[[2023,3,21]]},"abstract":"<jats:p>Background: Little is known regarding healthcare expenditures for patients with dementia with Lewy bodies (DLB) during the end of life. Objective: This study estimated Medicare expenditures during the last 5 years of life in a decedent sample of patients who were clinically diagnosed with Alzheimer\u2019s disease (AD) or DLB and had autopsy confirmed diagnosis. Methods: The study included 58 participants clinically diagnosed with mild dementia at study entry (AD: n\u200a=\u200a44, DLB: n\u200a=\u200a14) and also had autopsy-confirmed diagnoses of pure AD (n\u200a=\u200a32), mixed AD+Lewy body (LB) (n\u200a=\u200a5), or pure LB (n\u200a=\u200a11). Total Medicare expenditures were compared by clinical and pathology confirmed diagnosis, adjusting for sex, age at death, and patient\u2019s cognition, function, comorbidities, and psychiatric and extrapyramidal symptoms. Results: When pathology diagnoses were not considered, predicted annualized total Medicare expenditures during the last 5 years of life were similar between clinically diagnosed AD ($7,465\u00b11,098) and DLB ($7,783\u00b11,803). When clinical diagnoses were not considered, predicted expenditures were substantially higher in patients with pathology confirmed mixed AD+LB ($12,005\u00b12,455) than either pure AD ($6,173\u00b1941) or pure LB ($4,629\u00b11,968) cases. Considering clinical and pathology diagnosis together, expenditures for patients with clinical DLB and pathology mixed AD+LB ($23,592\u00b13,679) dwarfed other groups. Conclusion: Medicare expenditures during the last 5 years of life were substantially higher in patients with mixed AD+LB pathology compared to those with pure-AD and pure-LB pathologies, particularly in those clinically diagnosed with DLB. Results highlight the importance of having both clinical and pathology diagnoses in examining healthcare costs.<\/jats:p>","DOI":"10.3233\/jad-221021","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T11:30:06Z","timestamp":1675769406000},"page":"457-466","source":"Crossref","is-referenced-by-count":1,"title":["Costs During the Last Five Years of Life for Patients with Clinical and Pathological Confirmed Diagnosis of Lewy Body Dementia and Alzheimer\u2019s Disease"],"prefix":"10.1177","volume":"92","author":[{"given":"Carolyn W.","family":"Zhu","sequence":"first","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA"},{"name":"James J Peters VA Medical Center, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yian","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Taub Institute for Research in Alzheimer\u2019s Disease and the Aging, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton J.","family":"Kociolek","sequence":"additional","affiliation":[{"name":"Taub Institute for Research in Alzheimer\u2019s Disease and the Aging, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayri K.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Taub Institute for Research in Alzheimer\u2019s Disease and the Aging, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Taub Institute for Research in Alzheimer\u2019s Disease and the Aging, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaakov","family":"Stern","sequence":"additional","affiliation":[{"name":"Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA"},{"name":"Taub Institute for Research in Alzheimer\u2019s Disease and the Aging, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-221021_ref1","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1002\/mds.20535","article-title":"How to diagnose dementia with Lewy bodies: State of the art","volume":"20 Suppl 12","author":"Geser","year":"2005","journal-title":"Mov Disord"},{"key":"10.3233\/JAD-221021_ref2","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1017\/S0033291713000494","article-title":"The prevalence and incidence of dementia with Lewy bodies: A systematic review of population and clinical studies","volume":"44","author":"Vann Jones","year":"2014","journal-title":"Psychol 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