Epidemiology, Patient Characteristics, Treatment Patterns, and Costs of Mild Cognitive Impairment and Alzheimer’s Disease in Taiwan

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OBJECTIVES: Alzheimer's disease (AD) with mild cognitive impairment (MCI) and AD are stages along the cognitive decline continuum and represent growing public health concerns. This study aimed to assess the diagnosed prevalence, claims-identified incidence, treatment patterns, healthcare costs, comorbidities, and observed mortality outcomes of individuals with AD with MCI, and AD with dementia in Taiwan claims data over a 10-year period. METHODS: We conducted a retrospective cohort study using Taiwan's National Health Insurance Research Database. Individuals diagnosed with AD with MCI, or AD, between 2013 and 2022 were identified via ICD-9-CM and ICD-10-CM codes. Cross-sectional and longitudinal analyses examined epidemiology, treatment trends, costs, comorbidities, and mortality using descriptive statistics, survival analysis, and cost evaluations. RESULTS: The estimated prevalence of AD with MCI, and AD from the claims database, increased from 109 379 cases in 2018 to 131 053 in 2022. Among pharmaceutical interventions, donepezil usage was predominant and increased over time, whereas nonpharmacologic therapies remained minimal. Healthcare costs rose with disease severity, with nonpharmacological inpatient care being the highest expense. Cardiovascular and metabolic comorbidities were prevalent and increased with severity. Observed cumulative mortality proportions increased with advancing disease severity; patients with AD with severe dementia had the highest mortality burden (41.98% at year 3). CONCLUSION: AD with MCI and AD with dementia prevalence estimation is rising, demonstrating increasing costs and high comorbidity burdens. Disease severity is linked to higher mortality, reinforcing the need for integrated care and early cost-effective interventions to optimize outcomes in AD with MCI and AD with patients with dementia.

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