Observational studyJournal of the American Geriatrics Society2021
Identifying Medicare beneficiaries with dementia.
Observational study in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk factors and risk stratification approaches for delirium screening: A Geriatric Emergency Department Guidelines 2.0 systematic review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Case Definition for Diagnosed Alzheimer Disease and Related Dementias in Medicare.JAMA network open · 2024Pooled it
- PMEnvironmental health perspectives · 2026Article
- Dementia Is Associated With Adverse Outcomes After Nonruptured Abdominal Aortic Aneurysm Repair.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Incidence and Outcomes of Unplanned Intensive Interventions After Common Inpatient Surgeries: A Population-Based Cohort Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Impact of cognitive impairment on postoperative delirium and discharge disposition following knee arthroplasty: a Japanese nationwide propensity score-matched study.Archives of orthopaedic and trauma surgery · 2026Article
- Assigning Probable Dementia Status Using Routinely Collected Electronic Health Record Data.Journal of the American Geriatrics Society · 2026Article
- Article
- Methodological advances in claims-based dementia algorithms: integrating medication and clinical data for medicare populations.BMC medical research methodology · 2026Article
- Association of hospital quality and social determinants of health with short-term surgical outcomes among medicare beneficiary patients undergoing elective cancer surgery.American journal of surgery · 2026Article
- Association of coronary artery bypass with cognitive impairment in coronary artery disease across APO (ε) genotypes in AllofUS.medRxiv : the preprint server for health sciences · 2026Article
- Dementia Is Associated With Higher One-Year Mortality and Worse Patient-Centered Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction and Cardiogenic Shock.Cardiology research · 2026Article
- The association between midlife neighbourhood walkability and Alzheimer's disease in women: a prospective nested case-control study.Age and ageing · 2026Article
- Predicting Mortality and Costs After Emergency Department Visits by People With Dementia: Timing and Location Matter.Journal of the American Geriatrics Society · 2026Article
- Lithium therapy and delayed progression of Alzheimer's disease and related dementias in patients with bipolar disorder and mild neurocognitive disorders.medRxiv : the preprint server for health sciences · 2026Article
- An autonomous agentic workflow for clinical detection of cognitive concerns using large language models.NPJ digital medicine · 2026Article
- Dementia is associated with higher mortality and worse patient-centered outcomes after complex and high-risk coronary artery stenting.American heart journal plus : cardiology research and practice · 2026Article
- Association of coronary artery bypass with cognitive impairment in coronary artery disease across APO (ε) genotypes in AllofUS.BMJ neurology open · 2026Article
- Communication Surrounding Treatment Preferences for Older Adults With Dementia During Emergency Medical Services Response.Journal of the American Geriatrics Society · 2026Article
- Unraveling disparities in county-level dementia diagnosis prevalence across the United States.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
BACKGROUND/
objectivesNo data exist regarding the validity of International Classification of Disease (ICD)-10 dementia diagnoses against a clinician-adjudicated reference standard within Medicare claims data. We examined the accuracy of claims-based diagnoses with respect to expert clinician adjudication using a novel database with individual-level linkages between electronic health record (EHR) and claims.
designIn this retrospective observational study, two neurologists and two psychiatrists performed a standardized review of patients' medical records from January 2016 to December 2018 and adjudicated dementia status. We measured the accuracy of three claims-based definitions of dementia against the reference standard.
settingMass-General-Brigham Healthcare (MGB), Massachusetts, USA.
participantsFrom an eligible population of 40,690 fee-for-service (FFS) Medicare beneficiaries, aged 65 years and older, within the MGB Accountable Care Organization (ACO), we generated a random sample of 1002 patients, stratified by the pretest likelihood of dementia using administrative surrogates.
interventionNone. MEASUREMENTS: We evaluated the accuracy (area under receiver operating curve [AUROC]) and calibration (calibration-in-the-large [CITL] and calibration slope) of three ICD-10 claims-based definitions of dementia against clinician-adjudicated standards. We applied inverse probability weighting to reconstruct the eligible population and reported the mean and 95% confidence interval (95% CI) for all performance characteristics, using 10-fold cross-validation (CV).
resultsBeneficiaries had an average age of 75.3 years and were predominately female (59%) and non-Hispanic whites (93%). The adjudicated prevalence of dementia in the eligible population was 7%. The best-performing definition demonstrated excellent accuracy (CV-AUC 0.94; 95% CI 0.92-0.96) and was well-calibrated to the reference standard of clinician-adjudicated dementia (CV-CITL <0.001, CV-slope 0.97).
conclusionThis study is the first to validate ICD-10 diagnostic codes against a robust and replicable approach to dementia ascertainment, using a real-world clinical reference standard. The best performing definition includes diagnostic codes with strong face validity and outperforms an updated version of a previously validated ICD-9 definition of dementia.
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