P1‐296: Symptoms of Alzheimer's Disease (ad) Noted in U.s. Electronic Health Records Prior to the Diagnosis of Ad in Comparison to Matched Non‐demented Patients
Year: 2019
Type: article
Study design: Observational Study
Abstract: In previous analysis of a U.S. electronic health records (EHR) database, we found that approximately half of Alzheimer's disease (AD) patients had memory, behavior or cognition issues noted in the 5y prior to diagnosis. However, it remained uncertain whether symptoms were specific to early AD, rather than issues generally present among aging patients. Here, we explore the frequency of symptoms possibly related to AD in patients eventually diagnosed with AD and a non-AD comparison group. We conducted descriptive analysis of provider notes from Optum® de-identified EHR dataset of 54,100 U.S. patients aged 50+y with an AD ICD-9/10 code from 2007–2016 in an integrated delivery network with 5y history available (cases). For comparison, we selected age- and sex-matched non-cases (N=54,100) without any dementia diagnosis code or AD drug prescription. Index dates were the first dementia diagnosis date for AD and time-matched for non-cases. During the 5 years prior to index date, memory issues were noted in 45.0% of AD patients vs. 15.8% of non-AD patients, cognition issues in 36.8% AD vs. 21.0% non-AD, and neuropsychiatric symptoms (NPS) in 66.0% AD vs. 66.9% non-AD. Time trends in the difference between AD cases and non-cases were observed, depending on symptom type. Memory or cognition issues were more frequently noted in cases throughout the 5-year period, but the separation from non-cases heightened in the 2 years prior to index date. For most NPS symptoms, cases and non-cases were similar initially, and diverged in the 12 months prior to index date. Overall, patterns were similar in age-stratified analyses, although the oldest AD patients (85+y) typically were less likely to have memory, cognition, or neuropsychiatric symptoms noted compared to younger AD patients. Memory and cognition symptoms were more frequently noted among AD cases than non-cases during the 5y prior period, whereas most NPS comparatively increased only within the last 12 months before diagnosis. Overall, absolute percentages with symptoms noted remained small. EHRs could potentially be used in algorithms for early identification of dementia, but currently most patients with incipient dementia lack documentation of signs and symptoms that may critically inform prediction models.
Source: Alzheimer s & Dementia
Institution: Biogen (United States)
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2980945320