Prevalence of dementia among Veterans Affairs medical care system users.
OBJECTIVE
In an aging population, the number of veterans diagnosed with dementia is likely to increase. Knowledge of existing dementia prevalence will be beneficial in planning for future patient care needs. Our objectives were to assess the prevalence of the dementia diagnosis among those treated at Veterans Affairs (VA) medical centers and determine how it varies across race and Veterans Integrated Service Network (VISN).


METHODS
Data were collected on all veterans seen within the VA medical system from 1997 through the first half of 2001. Only veterans aged 65 and over were included in the study. Veterans were included if they had one of the following dementia ICD-9 codes: 290.XX, 291.2, 294.XX, 331.XX, 046.1, or 046.3.


RESULTS
The overall prevalence of dementia was 7.3%. The prevalence of dementia was similar among white patients and patients of other races, except African-American patients, in whom it was 50% higher. Across VISNs, the prevalence of dementia ranged from 5.8 to 9.4%. Alzheimer's disease was the most frequently diagnosed type of dementia within the VA, and inpatient service utilization and outpatient psychiatry visits by individuals with dementia were high relative to other VA patients.


CONCLUSIONS
The overall prevalence identified is consistent with that reported in the literature, as is the elevated prevalence in African-Americans versus whites. The data on prevalence by VISN may identify regional variation in either the types of dementia present or the diagnostic criteria used. The dementia diagnosis is clearly associated with substantial service use.
Krishnan
Laura L
LL
Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe, Houston, TX 77030, USA.
Petersen
Nancy J
NJ
Snow
A Lynn
AL
Cully
Jeffrey A
JA
Schulz
Paul E
PE
Graham
David P
DP
Morgan
Robert O
RO
Braun
Ursula
U
Moffett
Maurice L
ML
Yu
Hong-Jen
HJ
Kunik
Mark E
ME
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D008297:Male; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*