Using Natural Language Processing to Identify Home Health Care Patients at Risk for Diagnosis of Alzheimer's Disease and Related Dementias.

Journal: Journal of applied gerontology : the official journal of the Southern Gerontological Society
PMID:

Abstract

This study aimed to: (1) validate a natural language processing (NLP) system developed for the home health care setting to identify signs and symptoms of Alzheimer's disease and related dementias (ADRD) documented in clinicians' free-text notes; (2) determine whether signs and symptoms detected via NLP help to identify patients at risk of a new ADRD diagnosis within four years after admission. This study applied NLP to a longitudinal dataset including medical record and Medicare claims data for 56,652 home health care patients and Cox proportional hazard models to the subset of 24,874 patients admitted without an ADRD diagnosis. Selected ADRD signs and symptoms were associated with increased risk of a new ADRD diagnosis during follow-up, including: motor issues; hoarding/cluttering; uncooperative behavior; delusions or hallucinations; mention of ADRD disease names; and caregiver stress. NLP can help to identify patients in need of ADRD-related evaluation and support services.

Authors

  • Miriam Ryvicker
    Center for Home Care Policy & Research, VNS Health, New York, NY, USA.
  • Yolanda BarrĂ³n
    Center for Home Care Policy & Research, VNS Health, New York, NY, USA.
  • Jiyoun Song
    School of Nursing, Columbia University, New York, New York, USA.
  • Maryam Zolnoori
    Columbia University School of Nursing, New York, NY.
  • Shivani Shah
    College of Medicine, University of Florida, Gainesville, Florida, USA.
  • Julia G Burgdorf
    Center for Home Care Policy & Research, VNS Health, New York, NY, USA.
  • James M Noble
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H. Sergievsky Center and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.
  • Maxim Topaz
    Division of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.