ArticleJournal of general internal medicine2025
Effects of Functional Impairments and Frailty on the Association of Cognitive Impairment with Total Healthcare Costs: A Prospective Multi-cohort Study.
Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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Who cites it
1 citing paper in PubMed.
- Beyond Amyloid: Systemic and Brain Frailty as Determinants of Response to Anti-Amyloid Therapy in Alzheimer's Disease-A Conceptual Review.Medicina (Kaunas, Lithuania) · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundCognitive impairment is associated with higher total healthcare costs (THC) after accounting for demographic factors and comorbidity burden.
objectiveDetermine the proportion of incremental THC associated with cognitive impairment that is accounted for by functional impairments and frailty.
designFour prospective cohort studies of community-dwelling older adults are linked with each other and Medicare claims.
participantsEight thousand one hundred sixty-five community-dwelling, fee-for-service Medicare beneficiaries (mean age 79 years, 53% women, 79% non-Hispanic White). MAIN MEASURES: Cognitive impairment was defined by either abnormal cognitive tests or self-or-proxy report of a clinician diagnosis of dementia. Comorbidity was the count of claims-based chronic conditions. Functional impairments were self-reported difficulty performing four activities of daily living. Frailty was defined by the Cardiovascular Health Study phenotype or a claims-based deficit accumulation index (CFI). Annualized THC were ascertained for 36 months following an index exam. Incremental THC of cognitive impairment were mean THC in women (men) with cognitive impairment minus the mean THC in women (men) without cognitive impairment. KEY
resultsIncremental THC of cognitive impairment after adjustment for age, race, geographic region, and comorbidities was $6883 (95% CI, 3461-10,305) in women and $7276 (3298-11,254) in men. A substantial proportion of incremental THC of cognitive impairment were attributable to functional impairment, phenotypic frailty, or CFI individually (range 31.1-40.2% in women and 27.6-40.1% in men), while the combination of these three domains accounted for the majority of incremental THC (63.4% in women and 58.2% in men).
conclusionsFor both women and men, after accounting for demographics and comorbidity, approximately 60% of incremental THC associated with cognitive impairment was attributable to functional impairments and frailty. Investigation is warranted to determine if addressing these geriatric syndromes will mitigate their impact on THC among community-dwelling older adults with cognitive impairment.
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