%0 Journal Article %J J Alzheimers Dis %D 2021 %T Incremental Healthcare Utilization and Cost Burden of Comorbid Insomnia in Alzheimer's Disease Patients. %A Qureshi, Zaina P %A Thiel, Ellen %A Nelson, James %A Khandker, Rezaul %K Aged, 80 and over %K Alzheimer Disease %K Comorbidity %K Databases, Factual %K Female %K Health Care Costs %K Humans %K Male %K Medicare %K Patient Acceptance of Health Care %K Retrospective Studies %K Sleep Initiation and Maintenance Disorders %K United States %X

BACKGROUND: Insomnia is associated with worsened clinical outcomes among Alzheimer's disease dementia (AD) patients, increased caregiver burden, and healthcare utilization.

OBJECTIVE: This study aimed to characterize the incremental healthcare burden of insomnia in AD using real-world data.

METHODS: A retrospective observational study was conducted on AD patients selected from the IBM® MarketScan Commercial and Medicare Supplemental Databases. AD patients with claims-based evidence of insomnia were direct matched to a non-insomnia cohort based on demographic factors. Healthcare utilization and associated costs were assessed for a 12-month follow-up period.

RESULTS: A total of 3,500 insomnia AD patients and 9,884 non-insomnia AD patients were analyzed. The insomnia cohort had a higher comorbidity burden at baseline (mean score on Charlson Comorbidity Index 2.5 versus 2.2, p < 0.001) and higher proportions of patients with baseline diagnoses for other conditions including depression: 40%, insomnia cohort versus 25%, non-insomnia (p < 0.001). AD patients with insomnia were more likely to have a claim for inpatient hospitalizations (39.8%versus 32.3%), emergency room services (56.4%versus 48.0%), and skilled-nursing services (42.6%versus 31.9%) (all p < 0.05). Mean total annual healthcare costs during the 12-month follow-up period were significantly higher among AD patients with insomnia as compared to those without. (Mean costs: $37,356 versus $27,990, p < 0.001).

CONCLUSION: AD patients with comorbid insomnia are more likely to use higher-cost healthcare services such as inpatient hospitalization, and skilled nursing, and have higher total healthcare costs. This real-world analysis provides evidence that AD disease management should consider proper treatment of comorbid insomnia due to the incremental burden and cost implications.

%B J Alzheimers Dis %V 83 %P 1679-1690 %8 2021 %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/34420974?dopt=Abstract %R 10.3233/JAD-210713