Purpose
To assess diagnoses of Alzheimer’s disease and related dementias (ADRD) among Rhode Islanders using HealthFacts RI (All-Payer Claims Database (APCD)). To expand access to data sources and develop surveillance and monitoring tools that monitors ADRD burden in Rhode Island.
Collection Period
2018-2023
Data will be updated on an annual basis to include the most recent year with complete claims.
Key Information
The ADRD APCD database includes data on individuals diagnosed with ADRD who have had a claim submitted from a variety of payer sources from 2018 to 2023. These data are limited to Rhode Island adults aged 18 years or older who are insured, have had a claim submitted, and were diagnosed with the ADRD ICD-10 codes identified. When interpreting data stratified by Rhode Island Health Equity Zone (HEZ) it is important to note there are zip codes that overlap HEZs, therefore zip code data is included for each respective HEZ. Additionally, it should be considered there may be underdiagnosis of ADRD using the ICD-10 codes identified, and it is possible that a prominently used ICD-10 code in clinical practice was not included in the analysis. The same can be said for the cognitive assessment and advanced care planning percentages. It is possible that health care professionals use other billing codes than the care planning assessment codes included in the dashboard. Reporting may not have been possible for certain stratifications due to small sample sizes.
There are several data sources that provide an overview on the prevalence of ADRD in Rhode Island, such as the Alzheimer’s Association Rhode Island Facts and Figures reports. The APCD ADRD dashboard provides data on diagnoses from claims using specific ICD-10 codes and is not a population estimate of total prevalence. Key takeaways should not be used in comparison to other existing data sources that are not claims-based.
See State of Rhode Island Department of Health HealthFacts RI Database webpage for more information on the APCD.
Rhode Island Numbers
The summary information below are the main points from each dashboard topic.
Population Summary
- The number and percent of individuals in the APCD with an ADRD diagnosis has slightly decreased from 2018 to 2023, with 18,602 (2.88%) in 2018 versus 16,785 (2.42%) in 2023.
- The percent of individuals in the APCD diagnosed with ADRD who received a cognitive assessment and/or advanced care planning has increased over the past 5 years, with 13.62% in 2023, compared to 7.23% in 2018.
Cost of Care Summary
- Adults aged 85 and older is the highest costing population with an ADRD diagnosis. Despite this population having less APCD members with an ADRD diagnosis than those aged 65-84, the out-of-pocket expenses are higher.
- In 2023, the cost of care for insured adults with an ADRD diagnosis and claim submitted was approximately $229 million.
Risk Factors Summary
- Of all the modifiable risk factors that were examined, hypertension had the highest percent of diagnosis among individuals with ADRD in 2023, followed by prediabetes/diabetes, depression, tobacco use, obesity, hearing loss, and traumatic brain injury.
- In 2023, 79.21% of individuals diagnosed with ADRD, also had a diagnosis of hypertension, and nearly half (43.04%) also had prediabetes or diabetes.
Diagnosis Summary
- The highest percent of ADRD diagnoses in 2023 was unspecified dementia (64.18%), Alzheimer’s disease (36.62%), and mild cognitive impairment (32.94%).
- The three diagnoses with the fewest diagnosed individuals in 2023 were corticobasal degeneration (0.15%), frontotemporal dementia (1.79%), and dementia with Lewy bodies (2.13%).
Cognitive Assessment and Advance Care Planning Summary
- The percent of individuals diagnosed with ADRD that received a cognitive assessment and/or advanced care planning has steadily increased between 2018 to 2023.
- A majority of advanced care planning for individuals diagnosed with ADRD captured in the dashboard occurs in less than 30 minutes.