The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
59:M762-M766 (2004)
© 2004 The
Gerontological Society of America
1 Center for Health Policy, Law and Management,
Terry Sanford Institute of Public Policy, Duke University, Durham, North
Carolina.
2 Departments of Psychiatry, Geriatrics, and Medicine, Duke University
Medical Center, Durham, North Carolina.
3 Duke University Center for the Study of Aging and Human Development,
Durham, North Carolina.
Correspondence: Address correspondence to Donald Taylor, PhD, Box 90253, Duke University, Durham, NC 27708. E-mail: dtaylor@hpolicy.duke.edu
Background. Epidemiologic evidence suggests that African Americans have higher rates of Alzheimer's disease (AD) than do whites. Examining longitudinal trends in the number of persons who are identified as having AD in administrative databases may provide insights into this phenomenon.
Methods. We analyzed 9-year longitudinal data (1991–1999) for 29,679 Medicare beneficiaries who were screened for the National Long-Term Care Survey. Cases of AD were identified using ICD-9-CM diagnosis codes from Medicare claims files.
Results. Age-adjusted rates of Medicare beneficiaries identified as having AD rose from 1991–1999 for all groups studied, but particularly among African Americans. In 1991, African Americans made up 6.5% of the identified AD cases but comprised 11.0% of cases in 1999 (X2 = 6.79, p =.005). The rate of increase in identification of AD was particularly large for women who were aged 85 years and older.
Conclusions. Reasons for increased identification of AD in Medicare claims is likely multifactorial; sharp increases among African Americans may reflect improved access.