Primary Submission Category: Applications in Health and Biology
Environmental Noise Exposure and Annual Healthcare Cost and Utilization in Medicare Patients with Alzheimer’s Disease and Related Dementias: A Retrospective Cohort Study
Authors: Tien Tran, Shirley Huang, Edmund Seto, Zafar Zafari,
Presenting Author: Tien Tran*
Environmental noise may accelerate cognitive decline and increase healthcare costs and utilization in individuals with Alzheimer’s disease and related dementias (AD/ADRD). However, its impact on Medicare beneficiaries with AD/ADRD remains unclear. This study evaluates the association between chronic environmental noise exposure and healthcare costs and utilization (inpatient admissions and emergency department visits) in Medicare beneficiaries with AD/ADRD. We conducted a retrospective cohort study using a 25% random sample of Medicare fee-for-service beneficiaries (2017–2021). The sample included 1,064,686 individuals with AD/ADRD and continuous enrollment in Medicare Parts A and B. Chronic noise exposure was estimated at the ZIP-code level. Healthcare costs and utilization were measured annually. We used double negative controls method to address confounding: a negative control outcome (preceding-year utilization and costs) and a negative control exposure (subsequent-year noise exposure). Models were further adjusted for individual demographics, comorbidities, medication use, Medicare plan type, and county-level socioeconomic factors using the CDC Social Vulnerability Index.