How good are medical and death records for identifying dementia?

Schliep, Karen C.; Ju, Shinyoung; Foster, Norman L.; Smith, Ken R.; Varner, Michael W.; Østbye, Truls; Tschanz, JoAnn T.

doi:10.1002/alz.12526

Cited by 6 publications

(10 citation statements)

References 36 publications

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“…Further research that takes into account confounding of the exposure–mediator relationship and of the mediator–outcome relationship is warranted. Second, we recognize that using administrative health‐care records for dementia ascertainment may result in misclassification, especially in underdetection of dementia 41 . Worldwide there are barriers to receiving a diagnosis of a dementing disease, 48 an inherent limitation of studying dementia that impacts all research in this field.…”

Section: Discussionmentioning

confidence: 99%

“…We further classified dementia as AD, vascular dementia, or other/unspecified dementia including frontotemporal dementia, dementia with Lewy bodies, or all others. Our prior research indicates that UPDB administrative health records from 1996 to 2008 have 71% sensitivity and 81% specificity for all‐cause dementia diagnoses compared to gold‐standard research diagnoses 41 …”

Section: Methodsmentioning

confidence: 99%

“…Our prior research indicates that UPDB administrative health records from 1996 to 2008 have 71% sensitivity and 81% specificity for all‐cause dementia diagnoses compared to gold‐standard research diagnoses. 41 …”

Section: Methodsmentioning

confidence: 99%

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Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Schliep,

Shaaban,

Meeks

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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Introduction:Women with hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease. Whether HDP is also associated with later-life dementia has not been fully explored.Methods: Using the Utah Population Database, we performed an 80-year retrospective cohort study of 59,668 parous women.Results: Women with, versus without, HDP, had a 1.37 higher risk of all-cause dementia (95% confidence interval [CI]: 1.26, 1.50) after adjustment for maternal age at index birth, birth year, and parity. HDP was associated with a 1.64 higher risk of vascular dementia (95% CI: 1.19, 2.26) and 1.49 higher risk of other dementia (95% CI: 1.34, 1.65) but not Alzheimer's disease dementia (adjusted hazard ratio = 1.04; 95% CI: 0.87, 1.24). Gestational hypertension and preeclampsia/eclampsia showed similar increasedThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Schliep,

Shaaban,

Meeks

et al. 2023

Alz & Dem Diag Ass & Dis Mo

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“…International variations in the recording of dementia or AD as the UCOD can be further divided into variations in the underreporting of dementia or AD as a COD and variations in the recording of dementia or AD in part I of a death certificate. Several cohort studies have identified an underreporting of dementia or AD as a COD on death certificates 26–31 . Physicians in hypothetical countries A through C were more likely than those in Country D to diagnose AD as the COD.…”

Section: Discussionmentioning

confidence: 99%

“…Several cohort studies have identified an underreporting of dementia or AD as a COD on death certificates. [26][27][28][29][30][31] Physicians in hypothetical countries A through C were more likely than those in Country D to diagnose AD as the COD. Furthermore, physicians in hypothetical countries A and B were more likely than those in Country C to record AD in the death certificate resulting in higher recorded AD mortality rates in countries A and B (Fig.…”

Section: With Regard To the Timely Diagnosis Of Dementia And Ad Globa...mentioning

confidence: 95%

International Variations in Dementia and Alzheimer Disease Diagnosis and Certification Habits and Their Associations With Dementia and Alzheimer Disease Mortality

Chi,

Chu,

Chang

et al. 2023

Alzheimer Disease &Amp; Associated Disorders

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Objective: To examine international variations in national diagnosis and certification habits prefer recording dementia (D) versus Alzhiemer disease (AD) as the underlying cause of death (UCOD) and their associations with mortality rates of dementia and AD. Methods: We calculated proportions of D/D+AD and AD/D+AD deaths as proxies of national diagnosis and certification habits. Pearson correlation coefficients (r) were estimated to assess the associations of proportions with the mortality rates of dementia or AD among adults aged 75 to 84 years across 38 countries. Results: The countries with a high preference for recording dementia as the UCOD were Taiwan and Latvia with proportion of D/D+AD deaths of 92% and 88%, respectively, and those with a high preference for recording AD as the UCOD were Slovenia, Turkey, and Poland with proportion of AD/D+AD deaths of 100%, 99%, and 89%, respectively. The r values for the proportions and mortality rate for dementia and AD were 0.67 (95% CI: 0.44-0.81) and 0.46 (95% CI: 0.16-0.68), respectively. Conclusion: We identified a small number of countries with obvious natonal diagnosis and certification habits preferring dementia or AD and had moderate effects on international variations in the mortality rates of dementia and AD.

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Predicting the onset of Alzheimer’s disease and related dementia using electronic health records: findings from the cache county study on memory in aging (1995–2008)

Schliep,

Thornhill,

Tschanz

et al. 2024

BMC Med Inform Decis Mak

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Introduction Clinical notes, biomarkers, and neuroimaging have proven valuable in dementia prediction models. Whether commonly available structured clinical data can predict dementia is an emerging area of research. We aimed to predict gold-standard, research-based diagnoses of dementia including Alzheimer’s disease (AD) and/or Alzheimer’s disease related dementias (ADRD), in addition to ICD-based AD and/or ADRD diagnoses, in a well-phenotyped, population-based cohort using a machine learning approach. Methods Administrative healthcare data (k = 163 diagnostic features), in addition to census/vital record sociodemographic data (k = 6 features), were linked to the Cache County Study (CCS, 1995–2008). Results Among successfully linked UPDB-CCS participants ( n = 4206), 522 (12.4%) had incident dementia (AD alone, AD comorbid with ADRD, or ADRD alone) as per the CCS “gold standard” assessments. Random Forest models, with a 1-year prediction window, achieved the best performance with an Area Under the Curve (AUC) of 0.67. Accuracy declined for dementia subtypes: AD/ADRD (AUC = 0.65); ADRD (AUC = 0.49). Accuracy improved when using ICD-based dementia diagnoses (AUC = 0.77). Discussion Commonly available structured clinical data (without labs, notes, or prescription information) demonstrate modest ability to predict “gold-standard” research-based AD/ADRD diagnoses, corroborated by prior research. Using ICD diagnostic codes to identify dementia as done in the majority of machine learning dementia prediction models, as compared to “gold-standard” dementia diagnoses, can result in higher accuracy, but whether these models are predicting true dementia warrants further research. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-024-02728-4.

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How good are medical and death records for identifying dementia?

Cited by 6 publications

References 36 publications

Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

International Variations in Dementia and Alzheimer Disease Diagnosis and Certification Habits and Their Associations With Dementia and Alzheimer Disease Mortality

Predicting the onset of Alzheimer’s disease and related dementia using electronic health records: findings from the cache county study on memory in aging (1995–2008)

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