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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
The impact of mild cognitive impairment on healthcare utilization and costs: A UK Biobank study
Craig Ritchie1, Dominic Trepel2, Sophie Edwards3
1Scottish Brain Sciences Secondary affiliation to the University of St Andrews Edinburgh UK.
Introduction:
Mild cognitive impairment (MCI) is common in older adults, but the burden on patients and health systems is not well understood. We aimed to estimate the impact of MCI on healthcare utilization and costs.
Methods:
This was a matched cohort study in UK Biobank comparing healthcare costs and Alzheimer's disease (AD) dementia incidence rates in participants with MCI to propensity score-matched participants without MCI.
Results:
Of 164,508 eligible participants, 6605(4%) had cognitive testing scores consistent with MCI. Ten-year inpatient costs were 7.6% higher in MCI versus matched no-MCI participants, while 6-year primary care costs were 9.1% higher. Among MCI participants, AD dementia incidence rates were substantially higher than in non-MCI participants (7.2 5-year incidence rate ratio 95% CI: 3.3 to 15.7), and eventual AD dementia accrued higher additional inpatient costs (mean £20,199) over 10 years.
Discussion:
MCI is characterized by modestly higher healthcare utilization and costs. Subsequent AD dementia diagnosis was strongly associated with costs.
Highlights:
Baseline cognitive tests identified individuals with all-cause MCI in the UK Biobank.We compared individuals with MCI to propensity score-matched participants without MCI.Inpatient costs were 7.6% higher over 10 years, and primary care costs were 9.1% higher over 6 years for participants with MCI.AD dementia incidence rate ratio was 7.2 higher in participants with MCI.Among MCI participants, eventual AD dementia was a key driver of costs resulting in higher inpatient costs (mean £20,199) over 10 years.
Insights
Mild cognitive impairment (MCI) increases healthcare costs and utilization. Subsequent Alzheimer's disease (AD) dementia diagnosis significantly drives these higher costs, underscoring the long-term burden.
Area of Science:
- Gerontology
- Neurology
- Health Economics
Background:
- Mild cognitive impairment (MCI) is prevalent in older adults, yet its full impact on healthcare systems and patient burden remains unclear.
- Understanding the economic and utilization consequences of MCI is crucial for resource allocation and patient care planning.
Purpose of the Study:
- To quantify the impact of MCI on healthcare utilization and associated costs.
- To compare healthcare costs and Alzheimer's disease (AD) dementia incidence in individuals with MCI versus matched controls.
Main Methods:
- A matched cohort study was conducted using data from UK Biobank.
- Participants with MCI were propensity score-matched with individuals without MCI.
- Healthcare costs and AD dementia incidence rates were compared between the two groups.
Main Results:
- Individuals with MCI exhibited higher healthcare utilization, with 10-year inpatient costs 7.6% higher and 6-year primary care costs 9.1% higher than controls.
- The incidence rate of Alzheimer's disease (AD) dementia was substantially higher in the MCI cohort (incidence rate ratio of 7.2).
- Subsequent AD dementia diagnosis in MCI participants was associated with significant additional inpatient costs, averaging £20,199 over 10 years.
Conclusions:
- Mild cognitive impairment (MCI) is associated with moderately increased healthcare utilization and costs.
- The development of Alzheimer's disease (AD) dementia following MCI is a major contributor to long-term healthcare expenditures.
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