Abstract Details

Title Epidemiology of Frontotemporal Dementia in the Medicare Population

Topic General Neurology

Presentation(s) S24 - Hot Topics in Global Health and Neuroepidemiology (2:00 PM-2:12 PM)

Poster/Presentation
Number 006

Objective To examine the epidemiology and geospatial distribution of frontotemporal dementia (FTD) in United States (U.S.) Medicare beneficiaries.

Background FTD is caused by pathological neurodegeneration of the frontal and anterior temporal lobes and is highly prone to delayed or incorrect diagnoses. There have been limited population-based epidemiological studies describing FTD in the U.S., specifically within the Medicare population.

Design/Methods We conducted a case-control study from a random sample of Medicare beneficiaries in 2017-2018 using all incident FTD cases (ICD-10-CM: G31.0x; n=5,404) and randomly selected controls (n=27,046). We compared the demographics (age, sex, race, smoking, and healthcare utilization) and the geospatial patterns of our study population. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for all ICD-10-CM codes seen in the year prior to FTD diagnosis or control reference date. ORs were adjusted for all demographics. We used Bonferroni correction to account for multiple comparisons. ORs significant after Bonferroni correction were grouped into categories based on clinical relevance and recalculated. Additionally, we computed the standard incidence ratios (SIRs) of FTD at the county-level and used geospatial smoothing to map disease patterns.

Results

Cases were more likely than controls to be male (p<0.01), older (p<0.01), non-Hispanic white (p<0.01), and smokers (p<0.01). The group for memory disturbance/dementia (OR=12.4, 95% CI: 11.6-13.4), the ICD-10 code for “Wandering in Diseases Classified Elsewhere” (OR=8.0, 95% CI: 5.0-12.9), and groups for language disorders (OR=7.4, 95% CI: 6.4-8.6), abnormal behavior (OR=6.6, 95% CI: 5.5-8.0), and psychosis (OR=5.7, 95% CI: 4.9-6.5) were positively associated with FTD. We found higher SIRs for FTD in the Northeast, Eastern Montana, Pacific Northwest, and Central U.S.

Conclusions FTD in Medicare beneficiaries demonstrates expected demographic associations and diagnoses codes reflect FTD symptoms in the prodromal phase. The geospatial disease pattern is distinct from other neurodegenerative diseases and may inform future etiologic research.

Authors/Disclosures
Nishant Satapathy PRESENTER	Mr. Satapathy has nothing to disclose.
Jordan A. Killion, PhD (Barrow Neurological Institute)	Dr. Killion has received personal compensation for serving as an employee of CommonSpirit Health. The institution of Dr. Killion has received research support from The Michael J. Fox Foundation for Parkinson's Research (MJFF-000939). The institution of Dr. Killion has received research support from Department of Defense Grant (PD190057). The institution of Dr. Killion has received research support from Barrow Neurological Foundation. The institution of Dr. Killion has received research support from Kemper and Ethel Marley Foundation. The institution of Dr. Killion has received research support from Moreno Family.
ALEJANDRA CAMACHOSOTO, MD	The institution of Dr. CAMACHOSOTO has received research support from Michael J Fox Foundation . The institution of Dr. CAMACHOSOTO has received research support from NIH NCATS KL2 Career Development.
Brittany Krzyzanowski, PhD	Dr. Krzyzanowski has nothing to disclose.
Brad A. Racette, MD, FAAN (Barrow Neurological Institute)	Dr. Racette has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for American Regent. Dr. Racette has received personal compensation in the range of $500-$4,999 for serving as a advisory council with NIEHS.

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