{"doi":"10.1093/gerona/glaf030","title":"Incremental Healthcare Costs of Dementia and Cognitive Impairment in Community-Dwelling Older Adults: A Prospective Cohort Study","abstract":"BACKGROUND: Cognitive impairment and dementia are associated with higher healthcare costs; whether these increased costs are attributable to a greater comorbidity burden is unknown. We sought to determine associations of cognitive impairment and dementia with subsequent total and sector-specific healthcare costs after accounting for comorbidities and to compare costs by method of case ascertainment. METHODS: Index examinations (2002-2011) of 4 prospective cohort studies linked with Medicare claims. 8 165 community-dwelling Medicare fee-for-service beneficiaries (4 318 women; 3 847 men). Cognitive impairment identified by self-or-proxy report of dementia and/or abnormal cognitive testing. Claims-based dementia and comorbidities derived from claims using Chronic Condition Warehouse algorithms. Annualized healthcare costs (2023 dollars) were ascertained for 36 months following index examinations. RESULTS: 521 women (12.1%) and 418 men (10.9%) met the criteria for cognitive impairment; 388 women (9%) and 234 men (6.1%) met the criteria for claims-based dementia. After accounting for age, race, geographic region, and comorbidities, mean incremental costs of cognitive impairment versus no cognitive impairment in women (men) were $6 883 ($7 276) for total healthcare costs, $4 160 ($4 047) for inpatient costs, $1 206 ($1 587) for skilled nursing facility (SNF) costs, and $689 ($668) for home healthcare (HHC) costs. Mean adjusted incremental total and inpatient costs associated with claims-based dementia were smaller in magnitude and not statistically significant. Mean adjusted incremental costs of claims-based dementia versus no claims-based dementia in women (men) were $759 ($1 251) for SNF costs and $582 ($535) for HHC costs. CONCLUSIONS: Cognitive impairment is independently associated with substantial incremental total and sector-specific healthcare expenditures not fully captured by claims-based dementia or comorbidity burden.","journal":"The Journals of Gerontology Series A","year":2025,"id":522728,"datarank":0.2464513715102087,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0050356846450936195,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0050356846450936195,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":3,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9521,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":607983,"name":"Howard A Fink","orcid":"0000-0002-5985-5447","position":1,"is_corresponding":false},{"id":361152,"name":"Lisa Langsetmo","orcid":"0000-0003-2245-1657","position":2,"is_corresponding":false},{"id":362761,"name":"Allyson M. Kats","orcid":null,"position":3,"is_corresponding":false},{"id":361151,"name":"John T. Schousboe","orcid":"0000-0002-9329-0750","position":4,"is_corresponding":false},{"id":55010,"name":"Kristine Yaffe","orcid":"0000-0003-0919-3825","position":5,"is_corresponding":false},{"id":242503,"name":"Kristine E. Ensrud","orcid":"0000-0002-9069-3036","position":6,"is_corresponding":false},{"id":692607,"name":"Kerry M. Sheets","orcid":"0000-0002-3492-2404","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:49:58.707747Z","pmid":"39953969","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":[]}