Thomas H McCoy1, Larry Han2, Amelia M Pellegrini1, Rudolph E Tanzi3, Sabina Berretta4, Roy H Perlis1. 1. Center for Quantitative Health, Massachusetts General Hospital, Boston, MA, USA. 2. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 3. Genetics and Aging Research Unit, McCance Center for Brain Health, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA. 4. Translational Neuroscience Lab., Basic Neuroscience Division, McLean Hospital, Belmont, MA, USA.
Abstract
INTRODUCTION: Preventing dementia, or modifying disease course, requires identification of presymptomatic or minimally symptomatic high-risk individuals. METHODS: We used longitudinal electronic health records from two large academic medical centers and applied a validated natural language processing tool to estimate cognitive symptomatology. We used survival analysis to examine the association of cognitive symptoms with incident dementia diagnosis during up to 8 years of follow-up. RESULTS: Among 267,855 hospitalized patients with 1,251,858 patient years of follow-up data, 6516 (2.4%) received a new diagnosis of dementia. In competing risk regression, an increasing cognitive symptom score was associated with earlier dementia diagnosis (HR 1.63; 1.54-1.72). Similar results were observed in the second hospital system and in subgroup analysis of younger and older patients. DISCUSSION: A cognitive symptom measure identified in discharge notes facilitated stratification of risk for dementia up to 8 years before diagnosis.
INTRODUCTION: Preventing dementia, or modifying disease course, requires identification of presymptomatic or minimally symptomatic high-risk individuals. METHODS: We used longitudinal electronic health records from two large academic medical centers and applied a validated natural language processing tool to estimate cognitive symptomatology. We used survival analysis to examine the association of cognitive symptoms with incident dementia diagnosis during up to 8 years of follow-up. RESULTS: Among 267,855 hospitalized patients with 1,251,858 patient years of follow-up data, 6516 (2.4%) received a new diagnosis of dementia. In competing risk regression, an increasing cognitive symptom score was associated with earlier dementia diagnosis (HR 1.63; 1.54-1.72). Similar results were observed in the second hospital system and in subgroup analysis of younger and older patients. DISCUSSION: A cognitive symptom measure identified in discharge notes facilitated stratification of risk for dementia up to 8 years before diagnosis.
Keywords:
Alzheimer's disease; Cognition; Data mining; Dementia; Electronic health record; Machine learning; Natural language processing; Phenotype; Research domain criteria
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