{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:11:13Z","timestamp":1790683873767,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The extent that cognitive measures are documented in electronic health records (EHR) is important for quality care and addressing disparities in timely diagnosis of dementia or Alzheimer's disease (AD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis of U.S. EHR data to describe the frequency and factors associated with cognitive measures prior to diagnosis of dementia (N\u00a0=\u00a0111,125) or AD (N\u00a0=\u00a030,203).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only 11% of dementia patients and 24% of AD patients had a cognitive measure documented in the 5 years prior to diagnosis. Black race, older age, non\u2010commercial health insurance, lower mean neighborhood income, greater in\u2010patient stays, and fewer out\u2010patient visits were associated with lacking cognitive measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Extensive missing cognitive data and differences in the availability of cognitive measures by race, age, and socioeconomic factors hinder patient care and limit utility of EHR for dementia research. Structured fields and prompts for cognitive data inputs at the point of care may help address these gaps.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.12280","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T06:47:24Z","timestamp":1614754044000},"page":"1231-1243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Cognitive measures lacking in EHR prior to dementia or Alzheimer's disease diagnosis"],"prefix":"10.1002","volume":"17","author":[{"given":"Nancy","family":"Maserejian","sequence":"first","affiliation":[{"name":"Biogen  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Krzywy","sequence":"additional","affiliation":[{"name":"Biogen  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Eaton","sequence":"additional","affiliation":[{"name":"Biogen  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Galvin","sequence":"additional","affiliation":[{"name":"Department of Neurology Comprehensive Center for Brain Health University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12068"},{"key":"e_1_2_7_3_1","unstructured":"World Health Organization.Dementia: Key facts. Updated 19 Sept 2019.https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/dementia.2019."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadm.2015.12.002"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0435"},{"key":"e_1_2_7_6_1","unstructured":"Alzheimer's Association.Early Detection and Diagnosis of Alzheimer's Dementia. Policy Brief. Aug 2017. Available online:https:\/\/act.alz.org\/site\/DocServer\/Policy_Brief_\u2010_Early_Detection_and_Diagnosis_Brief__Assn.pdf?docID=53576.2017."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.22527"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235534"},{"key":"e_1_2_7_9_1","unstructured":"Public Health Agency of Canada.A Dementia Strategy for Canada. June2019.https:\/\/www.canada.ca\/en\/public\u2010health\/services\/publications\/diseases\u2010conditions\/dementia\u2010strategy.html"},{"key":"e_1_2_7_10_1","unstructured":"Alzheimer Europe.Dementia in Europe Yearbook 2018: Comparison of national dementia strategies in Europe.https:\/\/www.alzheimer\u2010europe.org\/Policy\/Country\u2010comparisons\/2018\u2010Comparsion\u2010of\u2010National\u2010Dementia\u2010Strategies\/Diagnosis\u2010post\u2010diagnostic\u2010support."},{"key":"e_1_2_7_11_1","unstructured":"U.S. Department of Health and Human Services.National Plan to Address Alzheimer's Disease.https:\/\/aspe.hhs.gov\/national\u2010plan\u2010address\u2010alzheimers\u2010disease#strategy2.B.2012."},{"key":"e_1_2_7_12_1","first-page":"13","article-title":"The prevalence, causes and consequences of undiangosed dementia in England: a record linkage study of the Cognitive Function and Ageing Study II","author":"Aldus CBC","year":"2017","journal-title":"Alzheimers Dement"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afv020"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4377-y"},{"key":"e_1_2_7_15_1","unstructured":"Gerontological Society of America (GSA) Workgroup on Cognitive Impairment Detection and Earlier Diagnosis.Report and Recommendations.https:\/\/www.geron.org\/images\/gsa\/documents\/gsaciworkgroup2015report.pdf.2015."},{"key":"e_1_2_7_16_1","unstructured":"American Academy of Neurology (AAN).Practice guideline update: mild cognitive impairment. 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