Factors of post‐stroke dementia: A nationwide cohort study in Taiwan

Li, Chien-Hsun; Chang, Yo-Chen; Chou, Mei-Chuan; Chen, Chun‐Hung; Ho, Bo-Lin; Hsieh, Sheng-Wen; Yang, Yuan‐Han

doi:10.1111/ggi.13725

Cited by 14 publications

(23 citation statements)

References 30 publications

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“…We demonstrated that patients with stroke had signi cantly higher incidence of dementia rates within 3year follow-up, and the incidence of dementia in male patients with stroke was higher than that of female patients with stroke. A pooled analysis of international data classi ed important contributors and risk factors to post-stroke dementia, and age over 65 and female gender are the mentioned risk factors [26,27]. The mean age in our study and the result that stroke patients had higher incidence of dementia match with this analysis, however the effect of gender did not.…”

Section: Discussionsupporting

confidence: 68%

Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

Chu

Chen

et al. 2020

Preprint

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BACKGROUND Stroke has been recognized as one of the major causes of adult disability worldwide, and post-stroke dementia may affect up to one-third of stroke survivors. This condition could be prevented if we could recognize and treat it earlier. Acupuncture as a complementary treatment for stroke has been shown to be beneficial for subsequent post-stroke rehabilitation. Our study investigated if acupuncture served additional advantages to decreasing the incidence of post-stroke dementia. METHODS We provide a retrospective cohort study from Taiwan National Health Insurance Research Database. This study compared the incidence of post-stroke dementia between cohorts with and without acupuncture treatment by calculating adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of acupuncture associated with post-stroke dementia using Cox proportional hazard regressions. The study group was composed of 9,547 patients who received first hospitalization for the treatment of stroke between 2002 and 2004; of which, 47,735 comparison patients were defined as the control group. The two groups were followed-up until the diagnosis of dementia presented or until the end of 2007. RESULTS The adjusted HRs of developing dementia among patients with stroke was 4.705 times the average (range, 4.353–5.085), and the incidence of dementia was higher in males. The study group tended to have less incidence of all kinds of dementia after acupuncture treatment, and patients without stroke receiving acupuncture had a lower probability of dementia than those untreated during the follow-up period. CONCLUSIONS This study presents evidence that acupuncture serves as an effective and alternative procedure to lower the risk of post-stroke dementia and the overall incidence of dementia in Taiwanese population.

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Section: Discussionsupporting

confidence: 68%

Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

Chu

Chen

et al. 2020

Preprint

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“…The Mini-Mental State Examination (MMSE) is a widely used tool to identify and rank cognitive impairment in elders [18]. It consists of a group of questions covering seven groups of cognitive functions, (1) orientation to time, (2) orientation to place, (3) registration of three words, (4) attention and calculation, (5) recall of three words, and (6) language and visual construction, with the maximum score of 30 points [19]. MMSE is found to be insensitive to the early signs of dementia, especially in highly educated individuals [20], so it is not considered in this study.…”

Section: Measurementsmentioning

confidence: 99%

“…Various risk factors make individuals prone to dementia. According to a nationwide cohort study in Taiwan, it is found that people with the disease of ischemic stroke, transient ischemic attack and cerebrovascular hemorrhage had a significantly greater risk of dementia afterward [5]. Community studies show that people with a lack of education or low education are more likely to have dementia or Alzheimer's disease [6].…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Clinic Visit Accompanied by Family and Dementia Severity in Taiwan

Chang

Lan

Chu

et al. 2021

IJERPH

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Introduction: This study analyzes the severity of dementia status with clinical dementia rating (CDR) score distribution among patients according to various family functional and sociodemographic issues. Methods: A cross-sectional study was performed in a regional hospital in Central Taiwan. The sample consisted of 318 patients who came to the clinic from May 2018 to April 2019, and who were diagnosed by the physicians with CDR scores ≧ 0.5. The Chi-Square test and binary logistic regression analyses were performed for inferential statistical analysis. Results: The mean age of the sample was 78.7 ± 8.51 years, and 61.6% of the samples’ CDR scores were equal or less than 1.0. Patients visiting the clinic were accompanied by spouses (21.7%), sons or daughters-in-law (40.6%), daughters (23.6%). Of the sample, 142 (44.3%) patients live with sons. Patients with a lower educational level had higher CDR scores. Compared to the patients who went to the clinic by themselves, the higher OR values of CDR scores ≧ 2 are found in patients who were accompanied by other relatives (OR = 18.871, 95% C.I. = 3.117–114.237, p = 0.001), or spouse (OR = 10.783, 95% C.I. = 1.996–58.245, p = 0.006). Conclusion: The family member who accompanied the patient to a clinic visit and the patient’s educational level are both significant issues relating to the severity of dementia.

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“…With TLD, researchers have identified several significant associations with high clinical impact, such as the association between nucleoside analogs and the risk of post liver resection hepatocellular carcinoma recurrence, and risk factors for poststroke dementia [41][42][43]. The thesis of the AOP model is that prescriptions solely comprising common D-M combinations in a large database, such as TLD, have a higher possibility of being substantiated.…”

Section: Principal Findingsmentioning

confidence: 99%

Assessing the International Transferability of a Machine Learning Model for Detecting Medication Error in the General Internal Medicine Clinic: Multicenter Preliminary Validation Study

Chin¹,

Song²,

Lien³

et al. 2021

JMIR Med Inform

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Background Although most current medication error prevention systems are rule-based, these systems may result in alert fatigue because of poor accuracy. Previously, we had developed a machine learning (ML) model based on Taiwan’s local databases (TLD) to address this issue. However, the international transferability of this model is unclear. Objective This study examines the international transferability of a machine learning model for detecting medication errors and whether the federated learning approach could further improve the accuracy of the model. Methods The study cohort included 667,572 outpatient prescriptions from 2 large US academic medical centers. Our ML model was applied to build the original model (O model), the local model (L model), and the hybrid model (H model). The O model was built using the data of 1.34 billion outpatient prescriptions from TLD. A validation set with 8.98% (60,000/667,572) of the prescriptions was first randomly sampled, and the remaining 91.02% (607,572/667,572) of the prescriptions served as the local training set for the L model. With a federated learning approach, the H model used the association values with a higher frequency of co-occurrence among the O and L models. A testing set with 600 prescriptions was classified as substantiated and unsubstantiated by 2 independent physician reviewers and was then used to assess model performance. Results The interrater agreement was significant in terms of classifying prescriptions as substantiated and unsubstantiated (κ=0.91; 95% CI 0.88 to 0.95). With thresholds ranging from 0.5 to 1.5, the alert accuracy ranged from 75%-78% for the O model, 76%-78% for the L model, and 79%-85% for the H model. Conclusions Our ML model has good international transferability among US hospital data. Using the federated learning approach with local hospital data could further improve the accuracy of the model.

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Factors of post‐stroke dementia: A nationwide cohort study in Taiwan

Cited by 14 publications

References 30 publications

Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

The Relationship between Clinic Visit Accompanied by Family and Dementia Severity in Taiwan

Assessing the International Transferability of a Machine Learning Model for Detecting Medication Error in the General Internal Medicine Clinic: Multicenter Preliminary Validation Study

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