Understanding resistance, resilience and repair: An analysis of electronic medical records to identify 'successful aging' free of Alzheimer's disease and related dementias. (7th December 2020)

• Record Type: Journal Article
• Authors: Miller, Amber H.; Marra, David E.; Anton, Stephen; Maraganore, Demetrius M.
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 11
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.043221
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: As the number of individuals living with Alzheimer's disease and related dementias (ADRDs) increases in the United States, it is important to discover ways to preserve and improve brain health across the lifespan through prevention. This is especially important for the rapidly growing over age 90 segment of the population ("oldest old"). This project defined 'Successful Aging' and utilized Electronic Medical Records (EMR) to understand the characteristics of successfully aged individuals over 90 throughout the State of Florida. This epidemiological investigation will also discover common lifestyle factors that contribute to the risk management of ADRDs. Method: A panel of distinguished researches, in the fields of dementia, aging, and biomedical informatics and health outcomes at the University of Florida, convened to develop a computable phenotype of "Successful Aging", derived from the EMR. Utilizing the OneFlorida Data Trust, a repository of healthcare data for 75% of Floridians (∼15 million patients), researchers computed a successful aging phenotype, using discretely coded demographics, ICD‐9/ICD‐10 diagnostic codes. Result: The research investigators identified 19 parameters of 'Successful Aging' and universally agreed to three primary criteria: over the age of 90, not residing in a nursing home, and free of ADRD. From the OneFlorida Data Trust, 281, 927 individuals were identified as residing in Florida, alive and over the age of 90, a 2.01% prevalence. In this over 90s population, 187, 514 (66.5%) did not have a diagnosis of ADRD and 94, 413 (33.5%) had ADRD diagnosis. Of the 187, 514 non‐ADRD individuals, 65, 008 (23.1%) did not reside in a nursing home zip code and exhibited the three primary criteria for successful aging. There were 45, 710 (16.2%) individuals who demonstrated all 19 parameter criteria (Figure 1). Conclusion: Florida is the third‐most populous state, with the highest percentage of elders, and the most ADRD per capita. Studies in this special population are crucial to understanding 'Successful Aging'. Future research will validate the EMR computed phenotype by contacting the 'Successful Agers' in Florida to further investigate demographic, medical, and social characteristics that promote resistance, resilience, and repair. This validation will lead to the development of preventive interventions that can reduce the lifestyle risk of developing ADRDs.