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Updated: Jun 1, 2026
09:17
Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Healthcare utilization and morbidity preceding a dementia classification: the Atherosclerosis Risk in Communities
Meng Pan1, Virginia Pate2, David Knopman3
1Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. mpan@unc.edu.
BMC Health Services Research
|May 30, 2026
Summary
Healthcare utilization changes, including increased hospitalizations and emergency department visits but decreased ambulatory care, may signal early dementia. Monitoring these patterns could aid in earlier identification of individuals at high risk for dementia.
Area of Science:
- Gerontology
- Neurology
- Public Health
Background:
- Dementia is often diagnosed late, despite healthcare utilization changes preceding diagnosis.
- Understanding pre-diagnostic healthcare patterns is crucial for early intervention.
Purpose of the Study:
- To examine healthcare utilization and chronic conditions in the pre-diagnostic period of dementia.
- To identify potential early indicators of dementia through healthcare seeking behaviors.
Main Methods:
- Analysis of Medicare data from Atherosclerosis Risk in Communities (ARIC) study participants.
- Comparison of healthcare utilization (hospitalization, ED, ambulatory care) 5 years before and 1 year after dementia classification.
- Use of negative binomial regression and inverse probability weights to analyze trends and balance cohorts.
Main Results:
- Participants with incident dementia showed higher hospitalization and ED use, and lower ambulatory care use up to 3 years before diagnosis.
- Increased hospitalizations for cardiovascular and cerebrovascular conditions were noted in the incident dementia group.
- Specific conditions like acute myocardial infarction, congestive heart failure, and stroke were more frequent in those who later developed dementia.
Conclusions:
- Healthcare utilization patterns, particularly increased hospitalizations and ED visits, can indicate early dementia.
- Cardiovascular and cerebrovascular diseases are significant contributors to dementia development.
- Monitoring healthcare-seeking behaviors may facilitate earlier dementia risk identification.
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