Management of multimorbidity in the midst of cognitive decline through clinical decision-support software.

IF 4.4 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2026-08-06 eCollection Date: 2026-07-01 DOI:10.1002/dad2.70395

Mark C Zelek, John Q Walker, Marwan N Sabbagh

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引用次数: 0

Abstract

Introduction: Multimorbidity - the coexistence of multiple chronic conditions - is common among older adults with cognitive impairment but is rarely addressed in an integrated manner.

Methods: We analyzed 17,915 adults aged 55 to 84 years (8997 receiving uMETHOD clinical decision-support care plans and 8918 from the National Health and Nutrition Examination Survey). The mean age was 69.0 years (SD 7.65; 95% CI: 68.86 to 69.1). Multimorbidity was quantified from diagnoses, labs, medications, vitals, and platform-inferred conditions. Associations with cognitive impairment were modeled using age- and sex-adjusted logistic regression.

Results: Cognitive impairment was reported in 25.91% of participants (97.5% with ≥2 conditions); each additional condition was associated with higher odds (odds ratio: 1.069; 95% CI: 1.061 to 1.077; p < 0.0001). Prominent clusters included vascular-metabolic disorders and micronutrient deficiencies.

Discussion: Cognitive vulnerability rises stepwise with disease burden. Precision, multimorbidity-aware decision support that integrates multidomain data can align cognitive and systemic care in real-world practice.

查看原文本刊更多论文

通过临床决策支持软件管理认知衰退中的多病。

多病-多种慢性疾病共存-在老年认知障碍患者中很常见，但很少以综合方式解决。方法：我们分析了17915名年龄在55至84岁之间的成年人（8997名接受uMETHOD临床决策支持护理计划，8918名来自全国健康与营养检查调查）。平均年龄为69.0岁（SD 7.65; 95% CI: 68.86 ~ 69.1）。从诊断、实验室、药物、生命体征和平台推断的条件对多病进行量化。使用年龄和性别调整的逻辑回归对认知障碍的关联进行建模。结果：25.91%的受试者存在认知障碍（97.5%伴有≥2种情况）；每一种额外的疾病都与更高的风险相关（风险比：1.069;95% CI: 1.061 ~ 1.077; p）。集成多领域数据的精确、多疾病感知决策支持可以在现实世界的实践中使认知和系统护理保持一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.