ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2022
Medicare Claims Data Underestimate Hallucinations in Older Adults With Dementia.
Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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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.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Evaluation of Mortality in Users of Pimavanserin Compared with Other Atypical Antipsychotics in Patients with Parkinson's Disease Psychosis: An Update.Drug safety · 2025Article
- Self-reported Visual Difficulty, Age-related Eye Disease, and Neuropsychiatric Outcomes in Older Adults.Ophthalmic epidemiology · 2025Article
- Strabismus and Strabismus Surgery in the U.S. Veterans Health Administration: Foundational Analyses of Electronic Health Record Data from 2000 to 2022.Journal of personalized medicine · 2025Article
- Impact of pimavanserin on prescribing practices in parkinson disease.Clinical parkinsonism & related disorders · 2025Article
- Channeling of New Neuropsychiatric Drugs-Impact on Safety and Effectiveness Studies.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023Article
- Hallucinations, Antipsychotic Use, and Mortality in Older Adults with Dementia: Retrospective Cohort Study of Two Medicare-Linked National Health Surveys.Drugs & aging · 2022Article
- Atypical antipsychotic use and mortality risk in Parkinson disease.Parkinsonism & related disorders · 2022Article
- Falls and Fractures in Patients with Parkinson's Disease-Related Psychosis Treated with Pimavanserin vs Atypical Antipsychotics: A Cohort Study.Drugs - real world outcomes · 2022Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectiveAdministrative claims data are used to study the incidence and outcomes of dementia-related hallucinations, but the validity of International Classification of Diseases (ICD) codes for identifying dementia-related hallucinations is unknown.
methodsWe analyzed Medicare-linked survey data from 2 nationally representative studies of U.S. older adults (the National Health and Aging Trends Study and the Health and Retirement Study) which contain validated cognitive assessments and a screening question for hallucinations. We identified older adults who had dementia or were permanent nursing home residents, and we combined this with questionnaire responses to define dementia-related hallucinations. Using Medicare claims data, we calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ICD codes for dementia-related hallucinations overall and within prespecified strata of age, neurologic comorbidity, and health care utilization.
resultsWe included 2,337 older adults with dementia in our cohort. Among 3,789 person-years of data, 1,249 (33.0%) had hallucations, and of these 286 had a qualifying ICD code for dementia-related hallucinations or psychosis (sensitivity 22.9%). Of 2,540 person-years of dementia without hallucinations, 284 had a diagnosis code for hallucinations (specificity 88.8%). PPV was 50.2%, and NPV was 70.1%. Sensitivity was greatest (57.0%) among those seeing a psychiatrist. Otherwise, there were no significant differences in sensitivity, specificity, PPV, or NPV by age, neurologic diagnosis, or neurologist care.
conclusionDementia-related hallucinations are poorly captured in administrative claims data, and estimates of their prevalence and outcomes using these data are likely to be biased.
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