Nishant Satapathy1, Jordan Killion2, Alejandra Camacho-Soto3, Brittany Krzyzanowski2, Brad Racette2
1The University of Arizona College of Medicine- Phoenix, 2Barrow Neurological Institute, 3University of Kansas Medical Center
Objective:
To examine the epidemiology and geospatial distribution of frontotemporal dementia (FTD) in United States (U.S.) Medicare beneficiaries.
Background:
FTD is caused by pathological neurodegeneration of the frontal and anterior temporal lobes and is highly prone to delayed or incorrect diagnoses. There have been limited population-based epidemiological studies describing FTD in the U.S., specifically within the Medicare population.
Design/Methods:
We conducted a case-control study from a random sample of Medicare beneficiaries in 2017-2018 using all incident FTD cases (ICD-10-CM: G31.0x; n=5,404) and randomly selected controls (n=27,046). We compared the demographics (age, sex, race, smoking, and healthcare utilization) and the geospatial patterns of our study population. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for all ICD-10-CM codes seen in the year prior to FTD diagnosis or control reference date. ORs were adjusted for all demographics. We used Bonferroni correction to account for multiple comparisons. ORs significant after Bonferroni correction were grouped into categories based on clinical relevance and recalculated. Additionally, we computed the standard incidence ratios (SIRs) of FTD at the county-level and used geospatial smoothing to map disease patterns.
Results:
Cases were more likely than controls to be male (p<0.01), older (p<0.01), non-Hispanic white (p<0.01), and smokers (p<0.01). The group for memory disturbance/dementia (OR=12.4, 95% CI: 11.6-13.4), the ICD-10 code for “Wandering in Diseases Classified Elsewhere” (OR=8.0, 95% CI: 5.0-12.9), and groups for language disorders (OR=7.4, 95% CI: 6.4-8.6), abnormal behavior (OR=6.6, 95% CI: 5.5-8.0), and psychosis (OR=5.7, 95% CI: 4.9-6.5) were positively associated with FTD. We found higher SIRs for FTD in the Northeast, Eastern Montana, Pacific Northwest, and Central U.S.
Conclusions:
FTD in Medicare beneficiaries demonstrates expected demographic associations and diagnoses codes reflect FTD symptoms in the prodromal phase. The geospatial disease pattern is distinct from other neurodegenerative diseases and may inform future etiologic research.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.