Mild memory impairment and medical care: Results from a population-based study

Mild memory impairment may be associated with an increased risk of medical care and greater health care costs. To investigate this question, a multi-ethnic cohort of I I90 older adults without dementia was identified from a population-based study (Washington Heights-Inwood Columbia Aging Project). All subjects completed a full battery of cognitive evaluations in 1996 or earlier and survived through 1996. Subjects with Medicare (1996, n=81 I) and NYC Medicaid claims (1996.1998, n=560) were then identified and examined relative to performance on tests of memory (a factor-analytic derived composite of seven terta). In multivariate models that adjusted for age, gender, and education, mean [median] Medicare charges in 1996 were $7713 [$7505], $7930 [$7726), and $5848 [$5677] for subjects with the lowest, middle, and highest memory test performance, respectively (p < .OOl by KroskalWallis [K-S] test of median scores). Mean [median] annual Medicaid costs by memory tenile were $16,115 [$15,794], $10.651 [$10,313], and $7552 [$7197] (p < .OOl by K-S test). Memory tertile groups did not differ in number of comorbid conditions. Low memory scores were associated with risk of incident dementia after 1996 (half of 59 subjects diagnosed with dementia during follow-up were in the lowest memory score tertile). Removing these subjects from analyses eliminated cost differences in Medicare but not Medicaid claims, suggesting that low memory performance in non-demented elders may be an independent risk factor for medical care costs that are captured in the Medicaid system