Dementia and long-term care – an analysis based on German health insurance data

Anne Fink, German Center for Neurodegenerative Diseases (DZNE)

The aim of this study is to investigate patients’ transitions to long-term care (LTC) following a diagnosis of incident dementia, and to determine whether these transitions differ depending on the type of physician who made the initial diagnosis: a general practitioner (GP) or a neurologist/psychiatrist (NP). Longitudinal claims data of the AOK are analyzed using a Kaplan-Meier estimator, a piecewise constant model, and temporary life table computations for the risk of needing LTC after the diagnosis of dementia incidence based on the diagnosing physician and the antidementia drug treatment prescribed. NP patients have a significantly reduced risk of needing LTC relative to GP patients. After a diagnosis of incident dementia, NP patients live two to 5.2 months longer without LTC than GP patients. Antidementia drug treatment has an adverse effect on LTC, while patients who are prescribed antidementia medication have an increased risk of needing LTC. Patients diagnosed by an NP have certain advantages relative to patients diagnosed by a GP. Further research is needed to determine whether these advantages are attributable to earlier detection or to different treatment regimens.