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Predictors and consequences of the timing and accuracy of clinical dementia diagnosis

Award Number: R01AG072559
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/15/2022
PERIOD OF PERFORMANCE END DATE: 01/31/2027

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Predictors and consequences of the timing and accuracy of clinical dementia diagnosis - Project Summary / Abstract The overarching goal of this project is to develop the evidence base around the predictors and consequences of clinical underdiagnosis vs early clinical diagnosis of Alzheimer’s disease and related dementias (ADRD) in healthcare settings. Many older persons who would meet diagnostic criteria for dementia—potentially more than half—are underdiagnosed in the healthcare setting, meaning they are diagnosed by their provider years after symptoms that meet criteria for dementia first emerge (i.e. late diagnosis) or are never diagnosed (i.e. missed diagnosis). We know relatively little about the factors that drive the timing of receipt of a clinical diagnosis of dementia. Advances in this area would allow us to address diagnostic disparities. In recent years, there has also been a push for early clinical diagnosis of dementia (i.e. identifying persons with dementia close to the time of symptom onset), despite lack of an effective disease-altering treatment for ADRD. The importance of an early clinical dementia diagnosis would be bolstered by clear evidence that it led to better long-term health for diagnosed patients, more appropriate healthcare utilization, or decreased medical costs. Conversely, evidence of harms would suggest a renewed focus on improving dementia care is warranted. However, the benefits and harms related to the timing of a clinical dementia diagnosis remain poorly characterized. This project will address these crucial gaps in understanding by leveraging unique data from 5 diverse, harmonized cohorts of aging from the Rush Alzheimer’s Disease Center (RADC) with robust cognitive assessment and linked Medicare claims records from 1991 to the present. This data is perfectly suited to these aims, as study-based dementia ascertainment is frequent (annual) and classification of dementia is not disclosed to participants—thus it is independent of clinical diagnosis in healthcare settings captured in the Medicare claims. We propose to characterize the factors that make older adults with dementia more or less likely to receive a clinical diagnosis around the time when they first meet criteria for ADRD (Aim 1), and to test whether those with early diagnosis have better health outcomes (Aim 2), and more appropriate healthcare utilization and less associated costs (Aim 3). These efforts are timely and have the potential to change public perception, clinical practice, and health policy. Patients and medical providers will be able to make better informed choices about when to seek or offer cognitive evaluation, while public health agencies, health systems, and health insurers will be able to use our findings to decide whether and how to promote early cognitive evaluation and diagnosis of dementia.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $520,983 )
2025	2025	RUSH UNIVERSITY MEDICAL CENTER	1653 W CONGRESS PKWY	CHICAGO	IL	60612	COOK	USA	Aging Research	000	4	1/10/2025	NON-COMPETING CONTINUATION	$520,983
														Subtotal = $520,983

Issue Date FY: 2024 ( Subtotal = $575,478 )
2024	2024	RUSH UNIVERSITY MEDICAL CENTER	1653 W CONGRESS PKWY	CHICAGO	IL	60612	COOK	USA	Aging Research	000	3	2/28/2024	NON-COMPETING CONTINUATION	$517,931
2024	2024	RUSH UNIVERSITY MEDICAL CENTER	1653 W CONGRESS PKWY	CHICAGO	IL	60612	COOK	USA	Aging Research	001	3	6/25/2024	NON-COMPETING CONTINUATION	$57,547
														Subtotal = $575,478

Issue Date FY: 2023 ( Subtotal = $572,248 )
2023	2023	RUSH UNIVERSITY MEDICAL CENTER	1620 W HARRISON ST	CHICAGO	IL	60612	COOK	USA	Aging Research	000	2	2/1/2023	NON-COMPETING CONTINUATION	$572,248
														Subtotal = $572,248

Issue Date FY: 2022 ( Subtotal = $582,706 )
2022	2022	RUSH UNIVERSITY MEDICAL CENTER	1653 W CONGRESS PRKWY	CHICAGO	IL	60612	COOK	USA	Aging Research	000	1	2/1/2022	NEW	$582,706
														Subtotal = $582,706

Grand Total All Awards = $2,251,415

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Predictors and consequences of the timing and accuracy of clinical dementia diagnosis

Award Number: R01AG072559

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/15/2022

PERIOD OF PERFORMANCE END DATE: 01/31/2027

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