The impact of mild cognitive impairment on healthcare utilization and costs: A UK Biobank study.

Abstract

Introduction: Mild cognitive impairment (MCI) is common in older adults, but the burden on patients and health systems is not well understood. We aimed to estimate the impact of MCI on healthcare utilization and costs.

Methods: This was a matched cohort study in UK Biobank comparing healthcare costs and Alzheimer's disease (AD) dementia incidence rates in participants with MCI to propensity score-matched participants without MCI.

Results: Of 164,508 eligible participants, 6605(4%) had cognitive testing scores consistent with MCI. Ten-year inpatient costs were 7.6% higher in MCI versus matched no-MCI participants, while 6-year primary care costs were 9.1% higher. Among MCI participants, AD dementia incidence rates were substantially higher than in non-MCI participants (7.2 5-year incidence rate ratio 95% CI: 3.3 to 15.7), and eventual AD dementia accrued higher additional inpatient costs (mean £20,199) over 10 years.

Discussion: MCI is characterized by modestly higher healthcare utilization and costs. Subsequent AD dementia diagnosis was strongly associated with costs.

Highlights: Baseline cognitive tests identified individuals with all-cause MCI in the UK Biobank.We compared individuals with MCI to propensity score-matched participants without MCI.Inpatient costs were 7.6% higher over 10 years, and primary care costs were 9.1% higher over 6 years for participants with MCI.AD dementia incidence rate ratio was 7.2 higher in participants with MCI.Among MCI participants, eventual AD dementia was a key driver of costs resulting in higher inpatient costs (mean £20,199) over 10 years.