Deep phenotyping of Alzheimer’s disease leveraging electronic medical records identifies sex-specific clinical associations

• DOI: 10.1038/s41467-022-28273-0
• Publication Date: 2022-02-03T11:07:29Z
• Authors: Alice S. Tang; Tomiko Oskotsky; Shreyas Havaldar; William G. Mantyh; Mesude Bicak; Caroline Warly So...; Sarah Woldemariam; Billy Zeng; Zicheng Hu; Boris Oskotsky; Dena Dubal; Isabel E. Allen; Benjamin S. Glick...; Marina Sirota
• Keywords: Male; Aging; Databases, Factual; Science; New York; 610; Comorbidity; Neurodegenerative; Alzheimer's Disease; Article; California; Cohort Studies; Databases; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; Clinical Research; Alzheimer Disease; Health Services and Systems; Health Sciences; Acquired Cognitive Impairment; 80 and over; Psychology; 2.1 Biological and endogenous factors; Electronic Health Records; Humans; Musculoskeletal Diseases; Vascular Diseases; Precision Medicine; Factual; Aged; Aged, 80 and over; Chi-Square Distribution; Mental Disorders; Q; Neurosciences; Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD); Brain Disorders; 4.1 Discovery and preclinical testing of markers and technologies; 3. Good health; Phenotype; Neurological; Dementia; Female; Nervous System Diseases

AbstractAlzheimer’s Disease (AD) is a neurodegenerative disorder that is still not fully understood. Sex modifies AD vulnerability, but the reasons for this are largely unknown. We utilize two independent electronic medical record (EMR) systems across 44,288 patients to perform deep clinical phenotyping and network analysis to gain insight into clinical characteristics and sex-specific clinical associations in AD. Embeddings and network representation of patient diagnoses demonstrate greater comorbidity interactions in AD in comparison to matched controls. Enrichment analysis identifies multiple known and new diagnostic, medication, and lab result associations across the whole cohort and in a sex-stratified analysis. With this data-driven method of phenotyping, we can represent AD complexity and generate hypotheses of clinical factors that can be followed-up for further diagnostic and predictive analyses, mechanistic understanding, or drug repurposing and therapeutic approaches.