Evidence map›Paper›PMID 40036035›Full record

ArticleJAMA network open2025

Hospice Use Among Medicare Beneficiaries With Parkinson Disease and Dementia With Lewy Bodies.

Meredith Bock, Siqi Gan, Melissa Aldridge, Krista L Harrison, Kristine Yaffe, Alexander K Smith, John Boscardin, Lauren J Hunt

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Meredith BockDivision of Geriatrics, Department of Medicine, University of California, San Francisco.
Siqi GanDivision of Geriatrics, Department of Medicine, University of California, San Francisco.
Melissa AldridgeBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Krista L HarrisonDivision of Geriatrics, Department of Medicine, University of California, San Francisco.
Kristine YaffePhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California, San Francisco.
John BoscardinDivision of Geriatrics, Department of Medicine, University of California, San Francisco.
Lauren J HuntPhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco.

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Alexander Keliimoeanu Smith · 2020 to 2026
$17.7M
Population Based Research for Alzheimer's Innovation (POP BRAIN)R35AG071916 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI YAFFE, KRISTINE · 2021 to 2024
$3.8M
Prognostic calculators for patients with Alzheimers disease and related dementiasR01AG057751 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI LEE, SEI, SMITH, ALEXANDER KELIIMOEANU · 2018 to 2021
$1.5M
Mentoring Researchers in Prognosis Research in Alzheimer’s Disease and Related DementiasK24AG068312 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2020 to 2026
$1.2M
Family Burden and Expenditures in HospiceR01NR018462 · NINR · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ALDRIDGE, MELISSA DIANE · 2019 to 2021
$1.1M
Hospice Use in Older Adults with Alzheimer's Disease and Related Dementias: Patterns, Policies, and Caregiver ExperiencesK76AG074924 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HUNT, LAUREN · 2021 to 2025
$1.1M
Palliative Care for People Living at Home with Advancing Dementia and Their CaregiversK01AG059831 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HARRISON, KRISTA LYN · 2019 to 2023
$720k
Population Based Research in Geriatric Palliative CareK07AG060270 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ALDRIDGE, MELISSA DIANE · 2018 to 2022
$631k
NIA NIH HHS K01 AG059831NIA NIH HHS K07 AG060270NIA NIH HHS K24 AG068312NIA NIH HHS K76 AG074924NIA NIH HHS P01 AG066605NIA NIH HHS P30 AG044281NIA NIH HHS R01 AG057751NIA NIH HHS R35 AG071916NINR NIH HHS R01 NR018462
6 · The paper itself

Abstract

Importance: Neurodegenerative disorders are now the most common reason that Medicare beneficiaries enroll in hospice for end-of-life care. People with all-cause dementia have high rates of suboptimal hospice use, but little is known about hospice use patterns in Lewy body disease, which includes both Parkinson disease (PD) and dementia with Lewy bodies (DLB). Objective: To compare patient characteristics, hospice agency characteristics, and patterns of use for beneficiaries with PD and DLB vs Alzheimer disease (AD). Design, Setting, and Participants: A retrospective cohort study including a 100% sample of national 2010-2020 calendar year Medicare data on hospice enrollees was performed. Data analysis was conducted from November 2023 to May 2024. Exposures: A diagnosis of PD or DLB, compared with AD as the reference group. Main Outcomes and Measures: Proportion of enrollees with short stays (<7 days), proportion with long stays (>180 days), proportion disenrolled for any reason before death, and disenrollment by type. Results: Of 11 327 324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 who met eligibility criteria (mean [SD] age, 85.2 [7.5] years; 781 763 [63.0%] female), there were 958 182 (8.4%) with a primary diagnosis of AD, 232 864 (2.1%) with PD, and 49 340 (0.4%) with DLB. People with PD were more likely to experience a long stay (odds ratio [OR], 1.15; 95% CI, 1.13-1.16) compared with AD, whereas the odds for those with DLB were not increased. However, people with either PD or DLB were less likely to be disenrolled for extended prognosis compared with AD (OR for DLB, 0.82; 95% CI, 0.79-0.85; OR for PD, 0.86; 95% CI, 0.85-0.88). People with PD were more likely to revoke hospice (OR, 1.29; 95% CI, 1.27-1.32) compared with AD. Conclusions and Relevance: In this cohort study of Medicare beneficiaries, hospice use patterns differed by dementia subtype. Higher likelihood of hospice revocation in PD raises important questions about unmet needs and highlights the need for more research around the experience of the end of life in this growing population.

Indexed as

Hospice CareHospicesLewy Body DiseaseMedicareParkinson DiseaseAgedAged, 80 and overAlzheimer DiseaseFemaleHumansMaleRetrospective StudiesUnited States

Identifiers

PMID40036035
PMCPMC11880951

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.