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

INTRODUCTION Home 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.METHODS Using 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.RESULTS Among 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).DISCUSSION There 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.

Automated summary

Home health (HH) is an important source of care for early-stage/undiagnosed Alzheimer's Disease and Related Dementias (ADRD) patients. This study aims to investigate the prevalence and predictors of incident ADRD diagnosis following HH. The results show that 10% of HH patients without diagnosed ADRD received an incident diagnosis within 1 year. Furthermore, HH patients with impaired overall cognition and community-referred patients were more likely to receive an incident ADRD diagnosis.