Sex Differences in Mortality and Health Care Utilization After Dementia Diagnosis

作者：Jay B. Lusk, Cassie B. Ford, Samir Soneji, Beau Blass, Talita D’Aguiar Rosa, Brystana G. Kaufman, Sneha Mantri, Li Fan, Brian Mac Grory, Ying Xian, Rashmita Basu, Kim G. Johnson, Richard O’Brien, Bradley G. Hammill, Emily C. O’Brien · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.2236 · 被引用次数：12 · 研究领域：Dementia and Cognitive Impairment Research、Heart Failure Treatment and Management、Geriatric Care and Nursing Homes

Importance: Sex differences may contribute to disparities in dementia outcomes. Objective: To understand the association between sex and mortality and health care services use after dementia diagnosis. Design, Setting, and Participants: This nationwide cohort study used Medicare enrollment data and took place from 2014 to 2021 with up to 8 years of follow-up. Analysis was performed from April 2024 to April 2025. This study included 5 721 711 patients 65 years or older with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes for dementia with at least 1 year of prior fee-for-service Medicare enrollment. Exposures: Sex, determined from Medicare enrollment data, derived from Social Security Administration records. Main Outcomes and Measures: The primary outcome was hazard of all-cause mortality, estimated with Cox proportional hazard regression. Secondary outcomes included hazards of use of common health care services, such as all-cause hospitalizations, skilled nursing facility stays, receipt of neuroimaging services, and physical/occupational therapy. Results: A total of 5 721 711 patients (3 302 579 female and 2 419 132 male) with incident dementia between 2014 and 2021 were included in the study. Female patients had lower crude 1-year mortality rates (21.8% vs 27.2% for male patients; P < .001) and lower rates of all-cause hospitalizations (46.9% vs 50.5%; P < .001). The unadjusted hazard of death associated with m...