To utilize the Medicare Files of Service Use (MFSU) to evaluate patterns in the incidence of aging-related diseases in the U.S. elderly population.
Age-specific incidence rates of nineteen aging-related diseases were evaluated with the National Long Term Care Survey (NLTCS) and the Surveillance, Epidemiology, and End Results (SEER) Registry data both linked to MSUF (NLTCS-M and SEER-M, respectively), using a developed algorithm for individual date at onset evaluation.
A random sample from the entire U.S. elderly population (Medicare beneficiaries) was used in NLTCS, and 26% of U.S. population is covered by the SEER Registry data.
34,077 individuals from NLTCS-M and 2,154,598 from SEER-M.
Individual medical histories were reconstructed using information on diagnoses coded in MFSU, dates of medical services/procedures, and Medicare enrollment/disenrollment.
The majority of diseases (e.g., prostate cancer, asthma, diabetes) had a monotonic decline (or decline following short period of increase) in incidence with age. A monotonic increase of incidence with age with a subsequent leveling off and decline was observed for myocardial infarction, stroke, heart failure, ulcer, and Alzheimer’s disease. An inverted U-shaped age pattern was detected for lung and colon carcinomas, Parkinson’s disease, and renal failure. The results obtained from the NLTCS-M and SEER-M were in agreement (excluding an excess for circulatory diseases in the NLTCS-M). A sensitivity analysis proved the stability of the evaluated incidence rates.
The developed computational approaches applied to the nationally representative Medicare-based datasets allows reconstruction of age patterns of disease incidence in the U.S. elderly population at the national level with unprecedented statistical accuracy and stability with respect to systematic biases.