Using Medicare claims in identifying Alzheimer's disease and related dementias
Siddharth Jain, Paul R. Rosenbaum, Joseph G. Reiter, Geoffrey J. Hoffman, Dylan S. Small, Jinkyung Ha, Alexander S. Hill, David A. Wolk, Timothy G. Gaulton, Mark D. Neuman, Roderic G. Eckenhoff, Lee A. Fleisher, Jeffrey H. Silber
Abstract
INTRODUCTION: This study develops a measure of Alzheimer's disease and related dementias (ADRD) using Medicare claims. METHODS: Validation resembles the approach of the American Psychological Association, including (1) content validity, (2) construct validity, and (3) predictive validity. RESULTS: We found that four items-a Medicare claim recording ADRD 1 year ago, 2 years ago, 3 years ago, and a total stay of 6 months in a nursing home-exhibit a pattern of association consistent with a single underlying ADRD construct, and presence of any two of these four items predict a direct measure of cognitive function and also future claims for ADRD. DISCUSSION: Our four items are internally consistent with the measurement of a single quantity. The presence of any two items do a better job than a single claim when predicting both a direct measure of cognitive function and future ADRD claims.