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[P2–276]: COMPARISON OF VERBAL MEMORY IMPAIRMENT IN EARLY VERSUS LATE ALZHEIMER DISEASE
Author(s) -
Keret Ophir,
ShapiraLichter Irit,
Steiner Israel,
Asvadurian Anita,
Scharff Irad,
Saad Limor Gertner,
Glik Amir
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.06.929
Subject(s) - early onset alzheimer's disease , recall , dementia , episodic memory , memory clinic , verbal fluency test , wechsler adult intelligence scale , audiology , neuropsychology , medicine , disease , psychology , cognition , pediatrics , psychiatry , cognitive psychology
ed descriptive analysis of provider notes from electronic health records (EHR) during the 5 year period prior to the AD diagnosis among 49,817 patients aged 50 years and older who received an ICD-9 or ICD-10 AD diagnosis between Jan 2007 and March 2016 in a U.S. nationwide EHR database. Results: Two to five years prior to the coded AD diagnosis, 61.6% of the patients lacked any provider note regarding memory, behavior or cognitive issues, whereas 26.6% of the patients had memory problems noted (alone or in combination with other symptoms), 24.4% behavior issues noted (alone or in combination), and 13.6% cognition issues noted (alone or in combination). In the 3 months to 2 years prior to diagnosis, provider notes of symptoms increased in patient records, with 41.4% having memory, 34.3% behavior, and 24.1% cognition issues noted; however, 45.8% still lacked such notes. Among those with a memory or behavior issue noted, the mean time between the first note and AD diagnosis was 2.1y (sd 1.5y). The greatest increase in the frequency of symptoms noted was in the 6-12 months prior to diagnosis. Notes specifically mentioning AD sharply increased in the 6 months prior to diagnosis, which may reflect a time period of differential diagnosis testing. Conclusions:Signs and symptoms of AD were not noted in the medical records for many of these AD patients prior to the coded AD diagnosis. These real world data indicate gaps in the assessment and documentation of cognitive impairment and early AD, which should be addressed to improve early detection of AD.