title: Functional limitations and health care resource utilization for individuals with cognitive impairment without dementia: Findings from a United States population-based survey.
abstract: BACKGROUND
  Little is known about functional limitations and health care resource utilization of people with cognitive impairment with no dementia (CIND).
  
  
  METHODS
  Respondents with stable or progressive cognitive impairment (CI) after the first (index) indication of CIND in 2000-2010 were identified from the Health and Retirement Study (HRS). Respondents never exhibiting CI were identified as potential controls. Propensity score-based optimal matching was used to adjust for differences in demographics and history of stroke. Differences between cohorts were assessed accounting for HRS survey design.
  
  
  RESULTS
  After matching, CIND respondents had more functional limitations (difficulty with ≥1 activities of daily living: 24% vs. 15%; ≥1 instrumental activities of daily living: 20% vs. 11%) and hospital stays (37% vs. 27%) than respondents with no CI (allP< .001). Seventy five percent of CIND respondents developed dementia in the observable follow-up (median time: ∼6 years).
  
  
  CONCLUSIONS
  Even before dementia onset, CI is associated with increased likelihood of functional limitations and greater health care resource use.
authors.affiliation: Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: J Scott
authors.initials: JS
authors.lastname: Andrews
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Urvi
authors.initials: U
authors.lastname: Desai
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Noam Y
authors.initials: NY
authors.lastname: Kirson
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Enloe
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Ljubica
authors.initials: L
authors.lastname: Ristovska
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: King
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.affiliation: Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Fleisher
authors.affiliation: Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Wenyu
authors.initials: W
authors.lastname: Ye
authors.affiliation: Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Kahle-Wrobleski
keywords: Burden; CIND; Dementia; Functional limitations; Health care resource use