Objective: The primary goal of this retrospective cohort study was to understand characteristics, healthcare resource use (HCRU) and costs of patients with PD before and after a new diagnosis and/or new treatment of cognitive impairment (CI; memory loss/MCI/dementia or dementia treatment).

Background: Mild cognitive impairment (MCI) and dementia are associated with increased disability and reduced quality of life in individuals with Parkinson’s disease (PD).

Method: Patients with PD newly diagnosed with CI (2010-2014) were identified using administrative claims data; date of first CI diagnosis/treatment was the index date. Patients were 19-89 years of age and continuously enrolled in a health plan for >3 years pre- and post-index date. Patient characteristics were evaluated across individual CI cohorts [MCI/memory loss (MCI/ML), dementia (DEM), and MCI/ML+dementia (MCI/ML + DEM)]. To evaluate HCRU and costs, patients in each CI cohort were matched (1:1) on age and gender with patients with PD, but with no CI.

Results: Of the 2,711 patients identified, 751, 1,024 and 936 patients were in the MCI/ML, DEM, and MCI/ML+DEM cohorts, respectively. Mean and median comorbidity scores (Deyo Charlson, RxRisk V) increased each year for all CI cohorts, especially the year before and after CI identification.  By year three post-index, 9.5%, 21.5% and 18.8% of the patients in the MCI/ML, DEM, and MCI/ML+DEM cohorts were in long-term care facilities, respectively. Compared to matched controls, patients in each cohort had higher hospital/emergency department (ED) use and total costs (P<0.05), especially during the year pre- and post-index. Costs peaked during the year prior to and after the index date, but declined slightly during years two and three post-index; costs for the matched controls showed a slower increase over the years. The DEM cohort had a greater proportion of patients with a hospitalization/ED visit, and higher median total costs than the other individual CI cohorts.

Conclusion: Comorbidity burden, HCRU and costs increased immediately before and after diagnosis of CI, especially among those newly diagnosed/treated for dementia. More research is needed to understand the differences and similarities in patients with PD identified with CI, and the impact of the severity of CI.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/understanding-characteristics-healthcare-resource-use-and-costs-of-patients-with-parkinsons-disease-prior-to-and-after-diagnosis-of-cognitive-impairment/