Classification of Dementia Severity in Taiwan Based on History-Based Clinical Diagnosis System

Abstract

Background/Aims: This study used HAICDDS screening questionnaire to classify the severity of dementia in Taiwan based on the clinical dementia rating scale. Methods: LDA was applied to 6,328 Taiwanese clinical patients for classification purposes. Clustering method was used to identify the associated influential symptoms for each severity level. Result: LDA shows only 36 HAICDDS questions are significant to distinguish the 5 severity levels with 80% overall accuracy and it increased to 85.83% when combining normal and MCI groups. Severe dementia patients have the most serious declination in most cognitive and functionality domains, follows by moderate dementia, mild dementia, MCI and normal patients. Conclusion: HAICDDS is a reliable and time-saved diagnosis tool in classifying the severity of dementia before undergoing a more in-depth clinical examination. The modified CDR may be indicated for epidemiological study and provide a solid foundation to develop a machine-learning derived screening instrument to detect dementia symptoms.

Operational Determination of Subjective Cognitive Decline, Mild Cognitive Impairment, and Dementia Using Sum of Boxes of the Clinical Dementia Rating Scale

“…This study is a retrospective analysis of the dementia registry database from the Show Chwan Healthcare System, currently applied in three centers in Taiwan (two in central Taiwan and one in southern Taiwan). In the database, the detailed clinical history of each participant was recorded using a structured questionnaire called the History-Based Artificial Intelligent Clinical Dementia Diagnostic System (HAICDDS), which has been well-validated (Lin et al, 2018 ; Chiu et al, 2019a , b , 2020 ; Tsai and Chiu, 2019 ; Chang et al, 2020 ; Wang et al, 2020 ; Zhu et al, 2020a , b ; Huang et al, 2021 ). In addition, CDR was used for staging dementia, and the daily function was assessed using the Instrumental Activities of Daily Living (IADL) Scale (Lawton and Brody, 1969 ) and Barthel Index (BI) (Mahoney and Barthel, 1965 ).…”

“…In our recent experience and studies using artificial intelligence (AI) for the diagnosis of cognitive impairment (CI) and dementia, the CDR and CDR-SB have become perfect references for machine learning in our newly designed questionnaires (Chiu et al, 2019a ; Chang et al, 2020 ; Zhu et al, 2020a , b ). Therefore, we highly recommend CDR as a further AI study.…”

Determining optimal cutoff scores of Cognitive Abilities Screening Instrument to identify dementia and mild cognitive impairment in Taiwan

“…Study subjects were selected from a longitudinal dementia registry dataset established for the History-based Artificial Intelligent Clinical Dementia Diagnostic System (HAICDDS) by the Show Chwan Healthcare System, which covers all of Taiwan except the eastern region [12][13][14][15][16]. The objective in establishing HAICDDS was to enable regular examinations (serum tests, cognitive assessment tests, and laboratory examinations) to facilitate the early detection and prevention of dementia.…”

Arrhythmia and other modifiable risk factors in incident dementia and MCI among elderly individuals with low educational levels in Taiwan

“…The participants were selected from a dataset built for the "History-Based Artificial Intelligent Clinical Dementia Diagnostic System (HAICDDS) Project. " As described in previous studies (Wang et al, 2013;Lin et al, 2018;Chang et al, 2020;Wang et al, 2020), the HAICDDS Project involved the retrospective analysis of a longitudinal dementia registry database from the Show Chwan Healthcare System. The aim of the project was to have participants receive regular examinations (serum tests, cognitive assessment tests, and laboratory examinations) to facilitate the early detection and prevention of dementia.…”