Diagnosed Prevalence and Health Care Expenditures of Mental Health Disorders Among Dual Eligible Older People.

Diagnosed Prevalence and Health Care Expenditures of Mental Health Disorders Among Dual Eligible Older People.

Filed under: Depression Treatment

Gerontologist. 2012 Dec 28;
Lum TY, Parashuram S, P Shippee T, Wysocki A, Shippee ND, Homyak P, Kane RL, Williamson JB

PURPOSE: Little is known about mental health disorders (MHDs) and their associated health care expenditures for the dual eligible elders across long-term care (LTC) settings. We estimated the 12-month diagnosed prevalence of MHDs among dual eligible older adults in LTC and non-LTC settings and calculated the average incremental effect of MHDs on medical care, LTC, and prescription drug expenditures across LTC settings.Methods:Participants were fee-for-service dual eligible elderly beneficiaries from 7 states. We obtained their 2005 Medicare and Medicaid claims data and LTC program participation data from federal and state governments. We grouped beneficiaries into non-LTC, community LTC, and institutional LTC groups and identified enrollees with any of 5 MHDs (anxiety, bipolar, major depression, mild depression, and schizophrenia) using the International Classification of Diseases Ninth Revision codes associated with Medicare and Medicaid claims. We obtained medical care, LTC, and prescription drug expenditures from related claims. RESULTS: Thirteen percent of all dual eligible elderly beneficiaries had at least 1 MHD diagnosis in 2005. Beneficiaries in non-LTC group had the lowest 12-month prevalence rates but highest percentage increase in health care expenditures associated with MHDs. Institutional LTC residents had the highest prevalence rates but lowest percentage increase in expenditures. LTC expenditures were less affected by MHDs than medical and prescription drug expenditures. IMPLICATIONS: MHDs are prevalent among dual eligible older persons and are costly to the health care system. Policy makers need to focus on better MHD diagnosis among community-living elders and better understanding in treatment of MHDs in LTC settings.
HubMed – depression

 

Relationship Between Markers of Insulin Resistance, Markers of Adiposity, HbA1c, and Cognitive Functions in a Middle-Aged Population-Based Sample: the MONA LISA study: Adiposity and cognitive functions.

Filed under: Depression Treatment

Diabetes Care. 2012 Dec 28;
Sanz CM, Ruidavets JB, Bongard V, Marquié JC, Hanaire H, Ferrières J, Andrieu S

OBJECTIVE To determine the relationship between markers of insulin resistance (fasting insulin and homeostasis model assessment of insulin resistance), markers of adiposity (BMI, waist circumference, and body fat), HbA(1c), and cognitive performances in a middle-aged population-based sample free of diabetes.RESEARCH DESIGN AND METHODS Our study sample consisted of 1,172 people aged 35-64 years (49% women), free of diabetes, and recruited between 2005 and 2007 in the MONA-LISA survey. Cognitive functions (memory, attention, and processing speed) were evaluated by neuropsychological tests: word-list learning test, digit symbol substitution test (DSST), word fluency test, and Stroop Test. Multiple logistic regressions were used to estimate the relationship between cognitive performance and metabolic markers. We serially adjusted for age, sex, education, and occupational status (model A), additionally for income, smoking, alcohol consumption, sedentarity, and psychotropic substance use (model B), and finally, included variables linked to the metabolic syndrome (hypertension, dyslipidemia, vascular disease, and C-reactive protein) and depression (model C).RESULTS Elevated markers of adiposity were associated with poor cognitive performance in tests evaluating processing speed. The probability of being in the lowest quartile of each test was nearly doubled for participants in the upper quartile of BMI, compared with those in the lowest one [BMI, adjusted odds ratio (OR) 2.18, P = 0.003 (DSST), and OR 2.09, P = 0.005 (Stroop Test)]. High HbA(1c) was associated with poor cognitive performance in DSST (adjusted OR 1.75, P = 0.037). Waist circumference was linked to poor cognitive performance in men but not in women.CONCLUSIONS Poor cognitive performance is associated with adiposity and hyperglycemia in healthy middle-aged people.
HubMed – depression

 

Effects of Type 2 Diabetes on 12-Year Cognitive Change: Results from the Maastricht Aging Study.

Filed under: Depression Treatment

Diabetes Care. 2012 Dec 28;
Spauwen PJ, Köhler S, Verhey FR, Stehouwer CD, van Boxtel MP

OBJECTIVETo examine the effects of baseline and incident diabetes on change in cognitive function over 12 years.RESEARCH DESIGN AND METHODSA sample of 1,290 individuals aged ?40 years at baseline, participating in the Maastricht Aging Study, were cognitively tested at baseline, after 6 years, and after 12 years. Of these, 68 participants had type 2 diabetes at baseline, and 54 and 57 had incident diabetes at the 6- and 12-year follow-up, respectively. Changes in performance on tests of information-processing speed, executive function, and verbal memory from baseline to 6- and 12-year follow-up were compared between groups using linear mixed models. Effects of diabetes on cognitive decline were adjusted for demographic variables, history of smoking, alcohol intake, and comorbid conditions, including hypertension, cardiovascular disease, BMI, and depression.RESULTSParticipants with baseline diabetes showed larger decline in information-processing speed (estimate -7.64; P < 0.01), executive function (21.82; P < 0.01), and delayed word recall (-1.35; P < 0.05) over the 12-year follow-up compared with control subjects. No significant difference in decline was observed for immediate word recall. Compared with control subjects, participants with incident diabetes showed subtle early decline in information-processing speed only. Interestingly, they did not show larger decline in any other cognitive domain.CONCLUSIONSIndividuals with baseline type 2 diabetes show accelerated cognitive decline, particularly in information-processing speed and executive function, compared with individuals without diabetes. In incident diabetes, decline in speed becomes detectable first, and cognitive decline seems to increase with increasing exposure time. HubMed – depression

 


 

TMS: Jeremy Roberts on The Genie Show part 2/2 – This is an interview from July of 2012 regarding TMS ( Transcranial Magnetic Stimulation ), a treatment for depression, conducted by Genie Joseph. Dr. Jeremy Roberts, based in Oahu Hawaii answers questions about TMS.

 

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