To determine if patients with dementia (PWD) seen by neurologists had lower odds of any dementia-related hospitalization, emergency department visit, medication prescription, or home health encounter than those who did not, after adjusting for demographic and clinical covariates.

Neurologists are trained in the evaluation and management of dementing diseases, which are increasingly prevalent worldwide. Per the World Health Organization, the estimated worldwide 2015 cost of dementia was $818 billion.

We analyzed data from the nationally representative Medical Expenditure Panel Survey (MEPS) from 2004-2012. We defined PWD as those ≥18 years in age with ICD-9-CM diagnostic codes of 290.xx, 294.xx, or 331.xx. A neurology visit (NV) was any outpatient or office-based provider visit with a neurologist in the year sampled with a dementia-associated diagnosis as above. Outcome variables included any dementia-associated emergency department visits, hospitalization, medications prescribed, or home health encounters within the year of sampling. We modeled associations between socioeconomic factors and medical comorbidities (as captured by a modified Charlson Comorbidity Index (CCI)) and the outcome variables using logistic regression.

We evaluated 841 PWD, representing 937,269 adults nationwide. Of those, 81 were seen by a neurologist; this represented 10.6% (95% CI 7.8%-14.2%). There were no significant differences in gender, age, race/ethnicity, household income, and CCI  ≥ 1 between groups. Any NV was significantly associated with more dementia-associated hospitalizations (adjusted OR 3.56, 95% CI 1.29-9.79). There was no significant association between any NV and other outcomes.

Neurology outpatient/office based provider visits were associated with increased odds of dementia-related hospitalizations even after adjustment for demographic and clinical covariates. This may indicate that PWD more commonly receive neurologic outpatient care in more advanced stages of dementia. The cross-sectional nature of the data does not allow for any causal inference, and further analyses are needed to clarify this issue.