{"doi":"10.1093/gerona/glad166","title":"Claims-Based Frailty Index as a Measure of Dementia Severity in Medicare Claims Data","abstract":"BACKGROUND: Dementia severity is unavailable in administrative claims data. We examined whether a claims-based frailty index (CFI) can measure dementia severity in Medicare claims. METHODS: This cross-sectional study included the National Health and Aging Trends Study Round 5 participants with possible or probable dementia whose Medicare claims were available. We estimated the Functional Assessment Staging Test (FAST) scale (range: 3 [mild cognitive impairment] to 7 [severe dementia]) using information from the survey. We calculated CFI (range: 0-1, higher scores indicating greater frailty) using Medicare claims 12 months prior to the participants' interview date. We examined C-statistics to evaluate the ability of the CFI in identifying moderate-to-severe dementia (FAST stage 5-7) and determined the optimal CFI cut-point that maximized both sensitivity and specificity. RESULTS: Of the 814 participants with possible or probable dementia and measurable CFI, 686 (72.2%) patients were ≥75 years old, 448 (50.8%) were female, and 244 (25.9%) had FAST stage 5-7. The C-statistic of CFI to identify FAST stage 5-7 was 0.78 (95% confidence interval: 0.72-0.83), with a CFI cut-point of 0.280, achieving the maximum sensitivity of 76.9% and specificity of 62.8%. Participants with CFI ≥0.280 had a higher prevalence of disability (19.4% vs 58.3%) and dementia medication use (6.0% vs 22.8%) and higher risk of mortality (10.7% vs 26.3%) and nursing home admission (4.5% vs 10.6%) over 2 years than those with CFI <0.280. CONCLUSIONS: Our study suggests that CFI can be useful in identifying moderate-to-severe dementia from administrative claims among older adults with dementia.","journal":"The Journals of Gerontology Series A","year":2023,"id":333382,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8587,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1034809,"name":"Stephanie Denise M. Sison","orcid":"0000-0003-3894-7219","position":1,"is_corresponding":false},{"id":270249,"name":"Ellen P. McCarthy","orcid":"0000-0003-1705-6249","position":2,"is_corresponding":false},{"id":270247,"name":"Sandra Shi","orcid":"0000-0001-6801-5602","position":3,"is_corresponding":false},{"id":593314,"name":"Natalia Gouskova","orcid":"0000-0001-7488-5014","position":4,"is_corresponding":false},{"id":493444,"name":"Kueiyu Joshua Lin","orcid":"0000-0003-4564-3715","position":5,"is_corresponding":false},{"id":270250,"name":"Dae Hyun Kim","orcid":"0000-0001-7290-6838","position":6,"is_corresponding":false},{"id":1060684,"name":"Chan Mi Park","orcid":"0000-0003-1880-048X","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T01:09:39.719497Z","pmid":"37428879","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}