Stratifying risk for dementia onset using large-scale electronic health record data: A retrospective cohort study

Topic: Health services, long-term care and technology

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.

Key findings

• 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.

New to this subject? Start with our plain-English guide: Digital health →

Study details

• Study designlongitudinal study
• Effect size2.4%; HR 1.63
• Evidence strengthModerate

Read the original

• DOI: 10.1016/j.jalz.2019.09.084
• PubMed: 31859230
• Original source →

Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.

@article{mccoy2020-31859230,
  author  = {McCoy, T. H. and Han, L. and Pellegrini, A. M. and Tanzi, R. E. and Berretta, S. and Perlis, R. H.},
  title   = {{Stratifying risk for dementia onset using large-scale electronic health record data: A retrospective cohort study}},
  journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
  year    = {2020},
  doi     = {10.1016/j.jalz.2019.09.084},
  pmid    = {31859230},
  url     = {https://doi.org/10.1016/j.jalz.2019.09.084}
}

Related studies in Digital health tools

• Machine learning prediction of incidence of Alzheimer's disease using large-scale administrative health data NPJ digital medicine · 2020-03-26 · usefulness score 59/100
• Real‐world prediction of early‐onset dementia by health record data: A multi‐center machine learning study Alzheimer s & Dementia · 2025-11-01 · usefulness score 36/100
• Electronic Health Record-Based Machine Learning Models for Predicting Revascularization, Amputation, and Cardiovascular Mortality in At-Risk Patients Research Square · 2026-10-11 · usefulness score 16/100
• Machine Learning Algorithm Using Electronic Chart-Derived Data to Predict Delirium After Elderly Hip Fracture Surgeries: A Retrospective Case-Control Study Frontiers in surgery · 2021-07-13 · usefulness score 57/100
• Associations between specific autoimmune diseases and subsequent dementia: retrospective record-linkage cohort study, UK Journal of epidemiology and community health · 2017-03-01 · usefulness score 62/100
• Multiple morbidity across the lifespan in people with Down syndrome or intellectual disabilities: a population-based cohort study using electronic health records The Lancet. Public health · 2023-04-26 · usefulness score 55/100

Also tagged “costs”

265 studies in the library carry the topic tag “costs”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 265 tagged studies.

• Anticipated reactions to learning Alzheimer's disease biomarker results Alzheimer's research & therapy · 2022-06-22 · usefulness score 66/100 · Disparities
• Disparities by Race and Ethnicity Among Adults Recruited for a Preclinical Alzheimer Disease Trial JAMA network open · 2021-07-01 · usefulness score 67/100 · Treatments
• The Value of Delaying Alzheimer's Disease Onset Forum for health economics & policy · 2014-11-04 · usefulness score 40/100 · Caregiving

Similar studies

• Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia 2020 · Digital health tools
• Dementia prevalence and incidence in a federation of European Electronic Health Record databases: The European Medical Informatics Framework resource 2018 · Digital health tools
• Identification of Physician-Diagnosed Alzheimer's Disease and Related Dementias in Population-Based Administrative Data: A Validation Study Using Family Physicians' Electronic Medical Records 2016 · Digital health tools
• Comorbidities of dementia in electronic health records: validation of a natural language processing app and comparison with data linkage 2026 · Risk factors
• The Contribution of Routinely Collected Clinical Data to Dementia Identification in Primary Care: A Cross-Sectional Study 2026 · Getting a diagnosis
• Evaluation of Medicare Claims Data as a Tool to Identify Dementia 2019 · Digital health tools

More on Digital health tools

• A review that covers this ground The validity of dementia diagnoses in routinely collected electronic health records in the United Kingdom: A systematic review Pharmacoepidemiology and drug safety · 2019-01-22 · usefulness score 62/100
• Newest in this subject Speaker-Wise Dementia Screening fromNaturalistic Speech with Lexical Entropy, Semantic Drift, and Multimodal Fusion Research Square · 2026-10-21 · Preprint — not yet peer-reviewed · usefulness score 16/100
• Newest in this subject Integrating Multisource Target Evidence with Machine-Learning Potency Prediction for Alzheimer’s Disease Drug Discovery bioRxiv · 2026-10-20 · Preprint — not yet peer-reviewed · usefulness score 16/100

See all studies in Digital health tools →