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Advanced Neurology ADRD comorbidities and senescence

that can significantly reduce beta-amyloid levels in the brain were defined within the TriNetX database using the
are available, clinically significant prevention or delaying of following inclusion criteria as search terms:
cognitive decline in patients with ADRD remains elusive. 1. United States patients only (150 million plus
Furthermore, ADRD has been reported to be associated individuals are in the database)
with multiple comorbidities 1,2 using a variety of data 2. Age 65 – 80 years (inclusive) OR ≥ 90 years
sources, such as hospital discharge records, medical 3. Health care visits occurred in 2021 – 2023
3
claims data, population-based studies, and registries. 8-10 4. A diagnosis of AD (ICD-10 code G30) and/or
6,7
4,5
Moreover, studies have reported on the number and type unspecified dementia (ICD-10 code F03) was used to
of comorbidities that significantly impact the progression define the patients with ADRD, and the absence of a
of cognitive decline, quality of life, and longevity of diagnosis of AD (ICD-10 code G30) or unspecified
patients with AD. 8,11-14 However, as the prevalence of dementia (ICD-10 code F03) was used to define the
ADRD is age-related, it has generally been considered non-ADRD patients.
that ADRD-associated comorbidities are due to the aging 2.3. Data compilation
process that differentially and independently affects
multiple organ systems and not due to a common underlying Datasets were compiled for each of the four above
pathophysiological process across organ systems. mentioned cohorts. In particular, the prevalence of signs,
symptoms, and diagnoses in each of the 22 ICD-10 chapters
The present study aimed to test the hypothesis that the was extracted from a sampling of a maximum of 10,000
comorbidity burden of older patients with ADRD (defined individuals from each of the 80+ HCOs. Scatter plots were
as 90+ years of age) is higher than that of younger patients generated for a visual comparison of the cohort datasets.
with ADRD (defined as 65 – 80 years of age). Therefore,
the relative prevalence of multiple medical disorders was 2.4. Statistical analysis
evaluated in the following four specific cohorts using real- Risk ratios were calculated for cohort comparisons based
world data (RWD): individuals aged 90+ years with and on the prevalence of ICD-10 codes between cohort groups.
without ADRD and individuals aged 65 – 80 years with
and without ADRD. Pearson correlation coefficients were calculated
between the data for each cohort comparison using the
2. Methods software available at https://www.socscistatistics.com/
tests/pearson/default.aspx (accessed October 9, 2024).
2.1. Analysis using the TriNetX analytics network
The significance of the difference between two
The TriNetX Analytics Network contains RWD from
anonymized electronic health records of more than correlation coefficients was evaluated using the software
available at https://www.analyticscalculators.com/calculator.
150 million Americans who have received care at over 80 aspx?id=104#google_vignette (accessed October 9, 2024).
health care organizations (HCOs) in the United States.
This database contains information on signs, symptoms, 3. Results
diagnoses, demographics, laboratory data, procedures,
and medications based on the International Statistical 3.1. Demographics of patients aged 65 – and
Classification of Diseases and Related Health Problems ≥90 years with and without ADRD with health care
10 Revision (i.e., International Classification of Diseases visits in 2021 – 2023
th
and Tenth Revision [ICD-10] codes). The healthcare payers The TriNetX database contained data for 239,670
include commercial, Medicaid, Medicare, and VA providers. individuals aged 65 – 80 years with a diagnosis of AD
TriNetX is compliant with the Health Insurance Portability (ICD-10 code G30) and/or unspecified dementia (ICD-10
and Accountability Act, the US federal law that protects the code G30) who visited a health care provider in 2021 – 2023
privacy and security of health care data, and any additional as well as data for 13,071,730 patients without either of
data privacy regulations applicable to the contributing HCO. these diagnoses in the same age group.
Because this study used only deidentified patient records
and did not involve the collection, use, or transmittal of The ≥90-year-old age cohort consisted of 184,060
individually identifiable data, it was exempted from the individuals with a diagnosis of AD (ICD-10 code G30) and/
Institutional Review Board approval. or unspecified dementia (ICD-10 code G30) who visited a
health care provider in 2021 – 2023 and 990,390 patients
2.2. Inclusion and exclusion criteria without either of these diagnoses during the same period.
The TriNetX database allows for a targeted search of As shown in Table 1, the 65 – 80-year-oldcohort with
patients with specific characteristics. Four patient cohorts ADRD had a mean age of 74 years, and the same age range

Volume 4 Issue 3 (2025) 101 doi: 10.36922/an.4046