Prevalence and predictors of incident ADRD diagnosis following a Medicare home health episode

Abstract

AbstractINTRODUCTIONHome health (HH) may be an important source of care for those with early‐stage/undiagnosed Alzheimer's Disease and Related Dementias (ADRD), but little is known regarding prevalence or predictors of incident ADRD diagnosis following HH.METHODSUsing 2010–2012 linked Master Beneficiary Summary File (MBSF) and HH assessment data for 40,596 Medicare HH patients, we model incident ADRD diagnosis within 1 year of HH via multivariable logistic regression.RESULTSAmong HH patients without diagnosed ADRD, 10% received an incident diagnosis within 1 year. In adjusted models, patients were three times more likely to receive an incident ADRD diagnosis if they had HH clinician‐reported impaired overall cognition (compared to patients without reported impairment) and twice as likely if they were community‐referred (compared to hospital‐referred patients).DISCUSSIONThere is a pressing need to develop tailored HH clinical pathways and protect access to community‐referred HH to support community‐living older adults with early‐stage/undiagnosed ADRD.