Dementia Diagnoses

A recent metastudy conducted by the University of Michigan shows a sharp increase in the diagnosis of dementia among older adults. The study examined 3.5 million individuals over the age of 67 who died between 2004 and 2017 and specifically focused on the bills their providers had submitted to the Medicare system–and any diagnosis of dementia that was provided in connection with the bills.

The study found that, in 2004, 35 percent of the invoices submitted for specific patients contained some mention of dementia, and by 2017 that number had risen to 47 percent. A similar increase was shown when researchers limited the data to individuals where providers had submitted two or more bills that referenced dementia, with multiple mentions increasing from 25 percent of patients in 2004 to 39 percent in 2017.

So, is the condition of dementia increasing, or is there some other cause? There are two reasons to suspect that alternative causes for the increase in diagnosis may be responsible. First, Medicare billing practices changed between 2004 and 2017 to allow providers to identify more diagnoses on their requests for payment, and second, during that time period there has been increased emphasis on dementia and its treatment, including the adoption of the National Plan to address Alzheimer’s Disease. With billing practices allowing for more diagnoses and heightened sensitivity to signs of dementia, it is not surprising that the number of diagnostic mentions has gone up.

Whatever the cause for the increase in formal diagnosis, it’s clear that many elderly Americans suffer from at least some symptoms of dementia–and I also suspect that people are a lot more open about it than used to be the case. The U of M metastudy showing the prevalence of this dreaded condition may be of comfort to the family members who have a loved one who is sinking into the depths of dementia: they are not alone.

3 thoughts on “Dementia Diagnoses

  1. Could a factor be the billing coding that providers use? I’d love to see a comment from someone in that world who could shed light on that. Is there more money in it for the docs when they check that box? I’m inherently skeptical (of course) based on my personal experience with procedures and looking closely at how things were coded (=$$$). For instance, every year the PA at my dermatologist’s office “freezes” a few pre-cancerous spots on my head and face. The bill lists these as multiple “surgeries,” racking up a nice payout from my insurance. After hernia surgery a few years ago, they got me up to walk around and I passed out. The bill reflected an additional $3,000 for a half-hour of some sort of “treatment” that involved sitting in a chair and eating a PB&J. Just throwing this out there …


    • That’s definitely something worth checking—but your experience suggests there may be deeper issues with relying on Medicare billing records as accurately reflective of underlying medical conditions. That’s disturbing!

      Liked by 1 person

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