Objective:

To measure all-cause healthcare resource use (HCRU) and costs of MCI subjects.

Background:

The economic burden of mild cognitive impairment (MCI), characterized by memory impairment or other cognitive decline, is poorly understood.

Design/Methods:

This retrospective cohort study used MarketScan® data (1Jan2014-31Dec2019) to identify subjects (“MCI cohort”) who: (1)were ≥50 years old; (2)had ≥1 MCI claim (ICD-9 331.83 or ICD-10 G31.84); (3)had no Alzheimer’s disease or related dementia (ADRD) ICD codes or medications pre-index date (first ICD code for MCI); and, (4 )had continuous enrollment for ≥2 years pre-/≥1 year post-index date. Subjects in a “control cohort” without MCI, ADRD or ADRD-related medications were matched by age, sex, geography, and index year. Subjects with Parkinson’s disease were excluded. Pair-wise t-test and chi² test were used to compare continuous and categorical variables, respectively. Logistic regression estimated odds ratios (ORs) for risk of medical conditions. Generalized linear models were used to compare HCRU and costs in the first 12 months post-index.

Results:

The study included 5,185 MCI and 15,555 control subjects (age 67 years, 58% female). The MCI cohort had higher Charlson and Elixhauser Comorbidity Indices than controls (1.5 vs 1.0 and 2.6 vs 1.8, respectively; p<0.0001). The MCI cohort had significantly higher risk for depression (OR=3.8) and stroke/transient ischemic attack (OR=3.3). Mean adjusted inpatient (0.3 vs 0.1), emergency (0.6 vs 0.3) and outpatient (29.1 vs 14.1) visits, and inpatient length of stay (09 vs 0.3 days) were higher in the MCI vs control cohort (all p<0.0001). Mean adjusted total costs were higher for the MCI vs control cohorts ($30,453 vs $13,376, p<0.0001).

Conclusions:

Despite the perception of being a mild condition, MCI was associated with more than double the economic burden. As the US population ages, early identification and intervention are key to delay progression on the Alzheimer’s disease continuum.