343-OR: Health Care Utilization in Older Adults with Diabetes and Dementia—Medical Expenditure Panel Survey (2000–2020)

Abstract

Adults with diabetes have two times the risk of developing dementia compared to adults without diabetes. The aim of this analysis was to determine the rates of healthcare utilization in older adults with diabetes and dementia. Data representing 102,176,914 adults aged 50 and older from the Medical Expenditure Panel Survey (2000-2020) were used. Inpatient, outpatient, emergency, dental, pharmacy, home-health, and total medical visits were dependent variables. The primary independent variable had 4 categories: no diabetes or dementia, diabetes only, dementia only, comorbid diabetes and dementia (DD). Covariates included age, race/ethnicity, sex, marital status, education, region, poverty, comorbidities, and survey year. Unadjusted and fully adjusted negative binomial regression models were run. Analyses were conducted using Stata v17.0, and statistical significance was p-value<0.05. In fully adjusted models, those with diabetes only (IRR:1.48; 95%CI:1.45, 1.51), dementia only (IRR:1.58; 95%CI:1.48, 1.69), and DD (IRR:1.59; 95%CI:1.43, 1.78) had significantly greater rate of pharmacy visits compared to individuals without diabetes or dementia. In addition, those with dementia only and DD had significantly higher rate of inpatient [dementia: (IRR:2.02; 95%CI: 1.60, 2.54); DD (IRR:1.56; 95%CI:1.02, 2.38)], ED [dementia: (IRR:1.63; 95%CI:1.44, 1.84)], and home health visits [dementia: (IRR:14.90; 95%CI:7.74, 28.69); DD (IRR:7.38; 95%CI:3.55, 15.34)] compared to individuals without diabetes or dementia. Adults aged 50 and older with comorbid diabetes and dementia have significantly higher rates of inpatient, pharmacy, and home health utilization compared to older adults with neither condition. In addition, having dementia is a key driver of healthcare utilization among adults aged 50 and older in the US. Disclosure A.Z.Dawson: None. A.Thorgerson: None. S.Linde: None. R.J.Walker: None. S.Bhandari: None. L.E.Egede: None. Funding American Diabetes Association (11-22-JDFHD-01 to A.Z.D.); National Institute of Diabetes and Digestive and Kidney Diseases (R01DK118038, R01DK120861); National Institute on Minority Health and Health Disparities (R01MD013826)