Table 3.
Prevalence and examples ADRD constructs in free-text clinical notes (N = 24,874)
| Domains & Constructs | Overall Sample | ADRD Dx During Follow-Up | Example of Construct in Free-Text Notes | |
|---|---|---|---|---|
| No | Yes | |||
| N = 24,874 | N = 15,973 | N = 8,901 | ||
| ADRD disease names | ||||
| Mentions of ADRD | 3.1% | 1.9% | 5.1% | Pt (patient) on chair hx (history) of last stage dementia [ADRD disease names] unable to answer questions |
| Symptoms | ||||
| Memory loss | 10.6% | 6.7% | 17.6% | Pt was at times tearful today is extremely forgetful [Memory loss] will ask the same question many times |
| Unspecified cognitive deficits | 2.2% | 1.4% | 3.8% | Pt is cognitively impaired [Unspecified cognitive deficits] and does not initiate any conversation |
| Communication problems | 3.9% | 2.9% | 5.5% | patient with significant word-finding difficulties, phonemic paraphasias, and verbal apraxia [Communication problems] is on speech tx (therapy) |
| Motor issues | 11.0% | 9.0% | 14.7% | pt is homebound due to unsteady gait [Motor issue] and steep stairs |
| Physically/verbally aggressive | 6.5% | 5.6% | 8.1% | pt combative refused vital signs yelled at vn (visiting nurse) [Physically aggressive] don’t touch me attempted to hit vn [Verbally aggressive] |
| Poor sleep | 2.7% | 2.3% | 3.3% | pt reports having trouble sleeping [Poor sleep] pt states he spends his nights thinking about many things |
| Wandering | 0.2% | 0.1% | 0.3% | pt continues to wander [Wandering] day and night trying to get out of apt |
| Disorientation | 0.5% | 0.2% | 0.9% | the client became disoriented [Disorientation] and did not recognize family nor her own location |
| Hoarding and clutter | 4.1% | 3.5% | 5.2% | pt’s surroundings are very crowded and pt appears to collect and hoard [Hoarding and clutter] with stacks of papers and magazines everywhere |
| Uncooperative | 7.2% | 5.6% | 10.1% | pt refused to [Uncooperative/ refusal] learn how to self-inject insulin |
| Depression or apathy | 11.4% | 10.0% | 14.0% | patient continues to be fatigued reports that hair is falling down and feels depress [Depression/ apathy] from fighting cancer |
| Anxiety | 19.6% | 18.1% | 22.4% | Pt very anxious [Anxiety] needs ongoing instruction on disease management |
| Delusions or hallucinations | 0.7% | 0.4% | 1.2% | pt continues to respond verbally to auditory hallucinations [Delusions/hallucinations] |
| Agitation | 2.8% | 2.0% | 4.3% | pt very agitated [Agitation] during vn visit |
| Confusion | 4.4% | 2.6% | 7.5% | pt continues to cry every afternoon more confused [Confusion] in evening |
| Bladder or bowel incontinence | 3.2% | 2.3% | 4.7% | pt is alert and orientedx3 incontinent in bowel and bladder [Bladder/bowel incontinence] skin is intact |
| Weight loss | 2.7% | 2.2% | 3.5% | pt reports 15lbs wt (weight) loss [Weight loss] x 6wks after her husband passed away |
| Poor/increased appetite | 2.7% | 2.1% | 3.6% | pt still co of abdominal bloating has no appetite [Poor/increased appetite] went to gastroenterologist last week |
| Trouble eating or swallowing | 1.8% | 1.3% | 2.7% | pt unable to swallow [Trouble eating or swallowing] Ceftin tabs due to large size pharmacy contacted and Ceftin confirmed to be ok to crush and mixed with pudding |
| Executive function problems | 1.5% | 1.1% | 2.3% | Patient needs constant verbal cues [Executive function problems] for safety and proper techniques |
| Functional issues (ADL/IADLs) | 0.4% | 0.4% | 0.5% | pt having increased difficulty feeding self [Functional issues] suggested weighted utensils |
| Hearing loss | 1.3% | 0.7% | 2.3% | pt lacks spontaneity and alertness due to hearing deficits [Hearing loss] |
| Caregiver stress | 0.2% | 0.2% | 0.4% | pts wife overwhelmed [Caregiver stress] and comfort provided |
| Interventions | ||||
| Addressing unmet needs | 0.7% | 0.7% | 0.7% | educate pts son on how to use [Indication of unmet need] a glucometer |
| Referrals for end-of-life care | 3.1% | 2.3% | 4.4% | pts md will discuss with pt possible transfer to hospice [Referrals for end-of-life care] |
| ADRD medications | 2.5% | 1.9% | 3.6% | Daughter to pick up aricept [Specific medications] from pharmacy |
| Home safety interventions | 57.7% | 54.6% | 63.3% | grab bar for toilet [Home safety interventions] ordered |