학술논문

Leveraging electronic health records and knowledge networks for Alzheimer’s disease prediction and sex-specific biological insights
Document Type
article
Source
Nature Aging. 4(3)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Prevention
Neurodegenerative
Brain Disorders
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Acquired Cognitive Impairment
Alzheimer's Disease
Dementia
Aging
Neurosciences
Aetiology
2.1 Biological and endogenous factors
Detection
screening and diagnosis
4.1 Discovery and preclinical testing of markers and technologies
Good Health and Well Being
Male
Humans
Female
Alzheimer Disease
Electronic Health Records
Apolipoproteins E
San Francisco
Clinical sciences
Language
Abstract
Identification of Alzheimer's disease (AD) onset risk can facilitate interventions before irreversible disease progression. We demonstrate that electronic health records from the University of California, San Francisco, followed by knowledge networks (for example, SPOKE) allow for (1) prediction of AD onset and (2) prioritization of biological hypotheses, and (3) contextualization of sex dimorphism. We trained random forest models and predicted AD onset on a cohort of 749 individuals with AD and 250,545 controls with a mean area under the receiver operating characteristic of 0.72 (7 years prior) to 0.81 (1 day prior). We further harnessed matched cohort models to identify conditions with predictive power before AD onset. Knowledge networks highlight shared genes between multiple top predictors and AD (for example, APOE, ACTB, IL6 and INS). Genetic colocalization analysis supports AD association with hyperlipidemia at the APOE locus, as well as a stronger female AD association with osteoporosis at a locus near MS4A6A. We therefore show how clinical data can be utilized for early AD prediction and identification of personalized biological hypotheses.