Cargando…

Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias

Alzheimer’s disease and related dementias (ADRD) is a multifactorial disease that involves several different etiologic mechanisms with various comorbidities. There is also significant heterogeneity in the prevalence of ADRD across diverse demographics groups. Association studies on such heterogeneou...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Yejin, Zhang, Kai, Savitz, Sean I., Chen, Luyao, Schulz, Paul E., Jiang, Xiaoqian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931358/
https://www.ncbi.nlm.nih.gov/pubmed/36812506
http://dx.doi.org/10.1371/journal.pdig.0000018
_version_ 1784889231718481920
author Kim, Yejin
Zhang, Kai
Savitz, Sean I.
Chen, Luyao
Schulz, Paul E.
Jiang, Xiaoqian
author_facet Kim, Yejin
Zhang, Kai
Savitz, Sean I.
Chen, Luyao
Schulz, Paul E.
Jiang, Xiaoqian
author_sort Kim, Yejin
collection PubMed
description Alzheimer’s disease and related dementias (ADRD) is a multifactorial disease that involves several different etiologic mechanisms with various comorbidities. There is also significant heterogeneity in the prevalence of ADRD across diverse demographics groups. Association studies on such heterogeneous comorbidity risk factors are limited in their ability to determine causation. We aim to compare counterfactual treatment effects of various comorbidity in ADRD in different racial groups (African Americans and Caucasians). We used 138,026 ADRD and 1:1 matched older adults without ADRD from nationwide electronic health records, which extensively cover a large population’s long medical history in breadth. We matched African Americans and Caucasians based on age, sex, and high-risk comorbidities (hypertension, diabetes, obesity, vascular disease, heart disease, and head injury) to build two comparable cohorts. We derived a Bayesian network of 100 comorbidities and selected comorbidities with potential causal effect to ADRD. We estimated the average treatment effect (ATE) of the selected comorbidities on ADRD using inverse probability of treatment weighting. Late effects of cerebrovascular disease significantly predisposed older African Americans (ATE = 0.2715) to ADRD, but not in the Caucasian counterparts; depression significantly predisposed older Caucasian counterparts (ATE = 0.1560) to ADRD, but not in the African Americans. Our extensive counterfactual analysis using a nationwide EHR discovered different comorbidities that predispose older African Americans to ADRD compared to Caucasian counterparts. Despite the noisy and incomplete nature of the real-world data, the counterfactual analysis on the comorbidity risk factors can be a valuable tool to support the risk factor exposure studies.
format Online
Article
Text
id pubmed-9931358
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-99313582023-02-16 Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias Kim, Yejin Zhang, Kai Savitz, Sean I. Chen, Luyao Schulz, Paul E. Jiang, Xiaoqian PLOS Digit Health Research Article Alzheimer’s disease and related dementias (ADRD) is a multifactorial disease that involves several different etiologic mechanisms with various comorbidities. There is also significant heterogeneity in the prevalence of ADRD across diverse demographics groups. Association studies on such heterogeneous comorbidity risk factors are limited in their ability to determine causation. We aim to compare counterfactual treatment effects of various comorbidity in ADRD in different racial groups (African Americans and Caucasians). We used 138,026 ADRD and 1:1 matched older adults without ADRD from nationwide electronic health records, which extensively cover a large population’s long medical history in breadth. We matched African Americans and Caucasians based on age, sex, and high-risk comorbidities (hypertension, diabetes, obesity, vascular disease, heart disease, and head injury) to build two comparable cohorts. We derived a Bayesian network of 100 comorbidities and selected comorbidities with potential causal effect to ADRD. We estimated the average treatment effect (ATE) of the selected comorbidities on ADRD using inverse probability of treatment weighting. Late effects of cerebrovascular disease significantly predisposed older African Americans (ATE = 0.2715) to ADRD, but not in the Caucasian counterparts; depression significantly predisposed older Caucasian counterparts (ATE = 0.1560) to ADRD, but not in the African Americans. Our extensive counterfactual analysis using a nationwide EHR discovered different comorbidities that predispose older African Americans to ADRD compared to Caucasian counterparts. Despite the noisy and incomplete nature of the real-world data, the counterfactual analysis on the comorbidity risk factors can be a valuable tool to support the risk factor exposure studies. Public Library of Science 2022-03-15 /pmc/articles/PMC9931358/ /pubmed/36812506 http://dx.doi.org/10.1371/journal.pdig.0000018 Text en © 2022 Kim et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Yejin
Zhang, Kai
Savitz, Sean I.
Chen, Luyao
Schulz, Paul E.
Jiang, Xiaoqian
Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias
title Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias
title_full Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias
title_fullStr Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias
title_full_unstemmed Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias
title_short Counterfactual analysis of differential comorbidity risk factors in Alzheimer’s disease and related dementias
title_sort counterfactual analysis of differential comorbidity risk factors in alzheimer’s disease and related dementias
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931358/
https://www.ncbi.nlm.nih.gov/pubmed/36812506
http://dx.doi.org/10.1371/journal.pdig.0000018
work_keys_str_mv AT kimyejin counterfactualanalysisofdifferentialcomorbidityriskfactorsinalzheimersdiseaseandrelateddementias
AT zhangkai counterfactualanalysisofdifferentialcomorbidityriskfactorsinalzheimersdiseaseandrelateddementias
AT savitzseani counterfactualanalysisofdifferentialcomorbidityriskfactorsinalzheimersdiseaseandrelateddementias
AT chenluyao counterfactualanalysisofdifferentialcomorbidityriskfactorsinalzheimersdiseaseandrelateddementias
AT schulzpaule counterfactualanalysisofdifferentialcomorbidityriskfactorsinalzheimersdiseaseandrelateddementias
AT jiangxiaoqian counterfactualanalysisofdifferentialcomorbidityriskfactorsinalzheimersdiseaseandrelateddementias