Notes on Alzheimer’s Disease

Why EHRs are essential for treating Alzheimer’s patients?

Background

Alzheimer’s disease is a serious problem in the U.S., affecting countless individuals and families across the nation. According to the Alzheimer’s Association, 1 in 3 seniors dies with the disease or another form of dementia. It is the sixth leading cause of death in the U.S.

Why EHRs are essential for treating Alzheimer’s patients?

What makes Alzheimer’s so difficult to diagnosis is how quickly the disease can change. Once a patient turns 65, his or her chances of developing the condition doubles every five years. Detailed health histories become even more important in catching any red flags as early as possible in old age. Following a positive diagnosis, an EHR continues to be an essential tool. Physicians and families can chart and monitor changes in memory, word use, independence and other changing factors closely tied to the disorder.

Aside from cognitive decline, patients living with Alzheimer’s face other health problems. Conditions like obesity, high blood pressure, Type 2 diabetes and others are not only early warning signs for Alzheimer​’s, but as the disease progresses, these sorts of problems become worse. Tracking these changes and documenting issues is helpful in building a targeted treatment plan.

Patient-facing EHR portals can help families because physicians can more clearly outline a treatment plan, and improved communication streams make it much easier to share new updates or information. One major consideration for keeping Alzheimer’s patients healthy and safe is finding ways to promote medication adherence. Missing a prescription or taking the wrong dosage can lead to very serious complications, but forgetfulness elevates this risk.

Moving forward, there is hope that the information provided by EHRs can help improve Alzheimer’s care across the board. Researchers are already leveraging patient data to identify evidence-based practices and uncover new options for combating the disease. As the population ages, EHR systems will only become more important. From start to finish, these platforms give physicians a better chance to diagnose and treat patients, as well as learn from their experiences.

EHR data used to study risk of Alzheimer’s disease

NorthShore’s Center for Brain Health

NorthShore’s Center for Brain Health are using the system’s EHR network to help identify patients that are at high risk of developing the disease. This is being done by building a risk prediction model based on data that is already in the healthcare organizations’ Epic system.

“We are using the data routinely captured by Epic to determine someone’s likelihood to be free of Alzheimer’s or their hazard of developing Alzheimer’s in the next five years,” Dr. Demetrius Maraganore, chairman of NorthShore’s Department of Neurology, told Healthcare Informatics. “And we can assign a risk score to that person and decide what risk score sets off bells and whistles so that we should inform this person and their doctor that this person is at increased risk.”

Electronic Health Records Based Prediction of Future Incidence of Alzheimer’s Disease Using Machine Learning (Yonsei University, Korea & Columbia University, USA)

Findings

Paper 1: Predicting dementia from primary care records: A systematic review and meta-analysis Meta-analysis showed that neuropsychiatric symptoms including depression, anxiety, and seizures, cognitive symptoms, and history of stroke, were positively associated with dementia. Cardiovascular risk factors such as hypertension, heart disease, dyslipidaemia and diabetes were positively associated with vascular dementia and negatively with AD. Sensitivity analyses showed similar results.

References:

[1] https://www.nuemd.com/news/2017/02/07/ehrs-essential-treating-alzheimers-patients
[2] https://www.nuemd.com/news/2015/08/21/ehr-data-used-study-risk-alzheimers-disease