% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@INPROCEEDINGS{Platen:283082,
      author       = {Platen, Moritz and Buchholz, Maresa and Raedke, Anika and
                      Scharf, Annelie and Glaeser, Eva and Iskandar, Audrey and
                      Hoffmann, Wolfgang and Michalowsky, Bernhard},
      title        = {{D}ifferentiation between early and severe stages of
                      dementia using diagnosis, prescription and utilization
                      patterns},
      journal      = {Alzheimer's and dementia},
      volume       = {21},
      number       = {S6},
      issn         = {1552-5260},
      reportid     = {DZNE-2025-01489},
      pages        = {e100898},
      year         = {2025},
      abstract     = {Background:Routinely collected claims data often lack
                      clinical parameters like dementia severity, which are
                      essential for treatments targeting early disease stages.
                      Diagnoses, prescriptions, and healthcare service utilization
                      patterns are commonly used to infer dementia severity, but
                      evidence validating these patterns is limited.Objective:To
                      identify and validate predictors (diagnoses, prescriptions,
                      and utilization patterns) for differentiating early and more
                      severe dementia stages.Methods:This cross-sectional analysis
                      used baseline data from 737 dementia patients. Comprehensive
                      assessments captured clinical data and healthcare
                      utilization. Diagnoses and prescribed medications were
                      extracted from general practitioner files. Dementia severity
                      was categorized by the Mini-Mental State Examination (MMSE):
                      early (≥27), mild (20–26), and moderate/severe (0–19).
                      Ordinal logistic regression analyzed associations between
                      predictors and severity, with average marginal effects (AME)
                      quantifying their impact. Specificity and negative
                      predictive values (NPV) were calculated to exclude milder
                      stages.Results:The sample $(56\%$ female, mean age 80) was
                      classified as early $(18\%),$ mild $(43\%),$ or
                      moderate/severe $(39\%).$ Predictors of moderate/severe
                      dementia included differential dementia diagnoses (OR 1.78),
                      antipsychotics (OR 3.22), antidementia drugs (OR 2.12), and
                      having a care level. Conversely, the number of medications
                      (OR 0.91) and therapy use (occupational, speech, or
                      physical; OR 0.68) were associated with milder stages.
                      Antipsychotics reduced early-stage likelihood by $14\%$ and
                      increased moderate/severe likelihood by $21\%.$ Antidementia
                      drugs reduced early-stage likelihood by $9\%$ and increased
                      moderate/severe likelihood by $13\%.$ Care level reduced
                      early-stage probability by $2–16\%,$ while moderate/severe
                      probability increased by $3–34\%.$ Antidementia and
                      antipsychotic prescriptions showed a specificity of $95\%$
                      and an NPV of $81\%,$ reliably excluding early dementia. For
                      mild dementia, specificity was $94\%,$ but NPV dropped to
                      $52\%.$ Differential diagnoses and care levels had a
                      specificity of $86\%$ and NPV of $81\%,$ effectively
                      distinguishing early dementia.Conclusion:Prescription and
                      diagnostic patterns reliably distinguish early from severe
                      dementia, validating their use for inferring dementia stages
                      from claims data. Further research should refine these
                      predictors to support guideline-based, early-stage dementia
                      therapies.},
      month         = {Jul},
      date          = {2025-07-27},
      organization  = {Alzheimer’s Association
                       International Conference, Toronto
                       (Canada), 27 Jul 2025 - 31 Jul 2025},
      cin          = {AG Michalowsky / AG Hoffmann},
      ddc          = {610},
      cid          = {I:(DE-2719)5000067 / I:(DE-2719)1510600},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)1 / PUB:(DE-HGF)16},
      doi          = {10.1002/alz70860_100898},
      url          = {https://pub.dzne.de/record/283082},
}