2023 Alzheimer's Association Research Fellowship (AARF)

Medicare Beneficiary and Caregiver Outcomes After an MCI Diagnosis

How may receiving a diagnosis of mild cognitive impairment impact the health and well-being of those at risk for dementia?

Elyse Couch, Ph.D.
Brown University
Providence, RI - United States

Background

According to numerous studies, brain changes linked to Alzheimer’s occur decades before memory loss and other clinical symptoms become evident. Individuals at risk of Alzheimer’s often have mild cognitive impairment (MCI), a state of more subtle memory loss before developing dementia. Individuals with MCI and early Alzheimer’s typically would benefit the most from treatments that can slow the progress of dementia. However, studies also show that many older Americans with MCI do not receive a formal diagnosis, and thus do not take advantage of early-stage treatment. Such findings indicate the need to better understand the population of Americans with undiagnosed MCI – including its size and demographic make-up. Researchers will also need to study how the lack of an MCI diagnosis affects health outcomes for these individuals and their caregivers.

Research Plan

Dr. Elyse Couch and colleagues will examine  the impact of an MCI diagnosis among U.S. Medicare beneficiaries and their caregivers. They will use data from several large studies of aging. First, the researchers will estimate the proportion of Medicare beneficiaries with MCI who have received a formal diagnosis. They will also explore whether certain demographic characteristics (such as race, sex or level of education) make one more or less likely to get diagnosed with MCI. Next, Dr. Couch’s team will compare the assess how likely individuals with diagnosed MCI were to develop Alzheimer’s and related dementia, compared with individuals who had undiagnosed MCI. Finally, the investigators will compare health outcomes of individuals with MCI who did or did not receive a diagnosis. Such outcomes include how well they utilized treatments and other medical care, and how well they and their caregivers preserved their overall wellbeing.           

Impact

Results from this study could help clarify the links between an MCI diagnosis and the health of individuals at risk of dementia and their caregivers. They could also lead to improved methods of diagnosing, treating and caring for individuals living with MCI in underserved communities.