UNSEEN AND UNDIAGNOSED - THE RELATIONSHIP OF SOCIAL ISOLATION TO UNDERDIAGNOSED DEMENTIA

Q: How did the study define social isolation?

Social isolation was measured using household contacts (marital status, household size, and children nearby) and community engagement (volunteering and religious attendance).

Q: What did the preliminary results show about socially isolated individuals?

In 2018, socially isolated individuals had higher undiagnosed dementia than non-isolated individuals (12.7% vs. 7.3%). In 2020, undiagnosed dementia rates were 9.8% vs. 7.4%, with overdiagnosis also differing.

Sep 29, 2026

Uploaded by LangkahRina

Social isolation may delay recognition of cognitive decline, contributing to underdiagnosed or misdiagnosed dementia. The study estimates the probability of undiagnosed dementia in older adults by linking U.S. Health and Retirement Study data with Medicare claims. Social isolation is assessed via household contacts and community engagement, while probable dementia classification uses the Power-Gianattasio Expert model and claims diagnoses use the Bynum algorithm. Results suggest higher undiagnosed dementia among isolated individuals in 2018 and similar patterns in 2020, indicating potential underestimation in claims-based research.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

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Abstract

Study design and data sources

Measures of social isolation

Dementia classification and outcomes

Preliminary results and implications

346 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.1168 UNSEEN AND UNDIAGNOSED: THE RELATIONSHIP OF SOCIAL ISOLATION TO UNDERDIAGNOSED DEMENTIA Ashwin Kotwal1, Irena Cenzer1, Min Hee Kim2, Ruijia Chen3, Carla Perissinotto1, Willa Brenowitz4, and Jacqueline Torres1, 1. University of California, San Francisco, San Francisco, California, United States, 2. Rutgers, New Brunswick, New Jersey, United States, 3. Boston University School of Public Health, Boston, Massachusetts, United States, 4. Kaiser Permanente, Portland, Oregon, United States Social isolation may delay recognition of cognitive decline, leading to underdiagnosis or misdiagnosis of dementia. We examined the probability of undiagnosed dementia among older adults based on social isolation status using data from the U.S. Health and Retirement Study (HRS) linked to Medicare claims. Social isolation was measured through household contacts (marital status, household size, children nearby) and community engagement (volunteering, religious attendance) . Probable dementia classification followed the Power-Gianattasio Expert model, maximizing accuracy across race and ethnicity subgroups, while the Bynum algorithm was applied to Medicare claims-based diagnoses. The primary outcome was dementia diagnosis status (correctly diagnosed, undiagnosed, or overdiagnosed) based on probable dementia classification in a given HRS wave and a corresponding Medicare-based diagnosis in the three years prior or one year after. We estimated associations between social isolation and dementia diagnosis status. Preliminary estimates from 2018 and 2020 indicate that 26-27% of respondents were socially isolated, 14% had probable dementia, and 8-9% had a claims-based dementia diagnosis. In 2018, socially isolated individuals had greater undiagnosed dementia than non-isolated individuals∼ (12.7% vs. 7.3%, p < 0.01), with similar overdiagno sis rates ( 2%) . In 2020, rates were similar by social isolation status (undiagnosed dementia: 9.8% vs. 7.4%; overdiagnosis: 3.7% vs. 2.7%) . Social isolation may contribute to disparities in timely dementia diagnosis due to reduced access to care and fewer social contacts recognizing cognitive changes. These findings suggest claims-based research may underestimate dementia cases among isolated individuals. Addressing social isolation asa public health concern may help mitigate disparities in dementia detection and care.

FAQs

How did the study define social isolation?

Social isolation was measured using household contacts (marital status, household size, and children nearby) and community engagement (volunteering and religious attendance).

How was dementia diagnosis classified in the study?

Probable dementia classification followed the Power-Gianattasio Expert model, while Medicare claims-based diagnoses used the Bynum algorithm.

What did the preliminary results show about socially isolated individuals?

In 2018, socially isolated individuals had higher undiagnosed dementia than non-isolated individuals (12.7% vs. 7.3%). In 2020, undiagnosed dementia rates were 9.8% vs. 7.4%, with overdiagnosis also differing.

Sep 29, 2026

Uploaded by LangkahRina