ArticlemedRxiv : the preprint server for health sciences2025
Diagnostic Reversion in Dementia Care: A Real-World Analysis of Mild Cognitive Impairment Diagnoses Following Dementia in a Large Electronic Medical Record System.
Silvia Miramontes, Umair Khan, Scott Zimmerman, Erin L Ferguson, Hunter Mills, Boris Oskotsky, Evan Phelps, Tomiko T Oskotsky, Anthony J Capra, M Maria Glymour and 2 more
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In one paragraphArticle in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 · The registryThe trial behind it
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4 · The recordCorrections and comments
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5 · Who and what moneyAuthors and funding
12 authors.
Silvia MiramontesBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.ORCID 0000-0001-5805-0500 Umair KhanBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.
Scott ZimmermanDepartment of Epidemiology, Boston University School of Public Health, Boston MA, USA 02118.
Erin L FergusonDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco CA, USA 94158.ORCID 0000-0003-3136-0001 Hunter MillsBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.
Boris OskotskyBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.
Evan PhelpsBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.
Tomiko T OskotskyBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.ORCID 0000-0001-7393-5120 Anthony J CapraBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.ORCID 0000-0001-9743-1795 M Maria GlymourDepartment of Epidemiology, Boston University School of Public Health, Boston MA, USA 02118.
Marina SirotaBakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco CA, USA 94158.
Elena TsoyGlobal Brain Health Institute, University of California San Francisco, San Francisco, CA, USA 94158.ORCID 0000-0001-8786-1791 Funding
Project 4: Social isolation as a driver of AD/ADRD incidence and disparitiesP01AG082653 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Jacqueline Marie Torres · 2024 to 2026
$23.6MAn Integrative Multi-Omics Approach to Elucidate Sex-Specific Differences in Alzheimers DiseaseR01AG060393 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SIROTA, MARINA · 2018 to 2022
$4.1MSocial determinants of racial and ethnic disparities in ADRD diagnostic pathwaysR21AG080410 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TSOY, ELENA · 2023 to 2024
$444kEvaluating social and clinical risk factors for the progression from Mild CognitiveImpairment to Alzheimer’s Disease and Related Dementias using Real World ClinicalDataF31AG085938 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LIZARRAGA, SILVIA MIRAMONTES · 2024 to 2025
$92kEvaluating routine clinical decisions in providing primary care for people living with Alzheimer's Disease or Alzheimer's Related Disorders: using electronic health records to provide timely evidenceF31AG085965 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FERGUSON, ERIN LAURA · 2024 to 2025
$86kNIA NIH HHS F31 AG085938NIA NIH HHS F31 AG085965NIA NIH HHS P01 AG082653NIA NIH HHS R01 AG060393NIA NIH HHS R21 AG080410
6 · The paper itselfAbstract
introductionIf mild cognitive impairment (MCI) is diagnosed after dementia, it suggests either the dementia diagnosis was premature, or the MCI diagnosis is incorrect. We investigated the prevalence and predictors of such "diagnostic reversion"-MCI diagnosis following dementia diagnosis-in a large academic health system.
methodsAmong 5,965 patients aged 50+ with incident dementia in UCSF Health electronic health records, we identified "reverters" with a subsequent MCI diagnosis. We used Group LASSO-regularized logistic regression and random forest models to identify predictors.
resultsReversion occurred in 13.7% of patients. Lower odds were observed among older adults (OR=0.95/year; 95% CI: 0.92-0.98), while higher odds were found among Spanish speakers (OR=2.26; 95% CI: 1.28-4.00), those with greater cardiovascular risk (OR=1.16; 95% CI: 1.01-1.33), and higher Charlson comorbidity burden (OR=1.09; 95% CI: 1.05-1.14). DISCUSSION: Diagnostic reversion is common and socially patterned, suggesting contributions from misdiagnosis, clinical uncertainty, or variability in clinical presentation and care setting.
Indexed as
cardiovascular riskdementiadiagnostic reversiondiagnostic trajectorieselectronic health records (EHR)health disparitieslanguage barriersmild cognitive impairmentmisdiagnosisreal-world datareal-world evidencesocial determinants of health
Identifiers
PMID40791721
PMCPMC12338929
What OpenQuestion holds
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LicenceCC BY-NC
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