Driving in Patients with Dementia: A CREDOS (Clinical Research Center for Dementia of South Korea) Study

Dementia Patient Segmentation Using EMR Data Visualization: A Design Study

(1) Background: The Electronic Medical Record system, which is a digital medical record management architecture, is critical for reliable medical research. It facilitates the investigation of disease patterns and efficient treatment via collaboration with data scientists. (2) Methods: In this study, we present multidimensional visual tools for the analysis of multidimensional datasets via a combination of 3-dimensional radial coordinate visualization (3D RadVis) and many-objective optimization (e.g., Parallel Coordinates). Also, we propose a user-driven research design to facilitate visualization. We followed a design process to (1) understand the demands of domain experts, (2) define the problems based on relevant works, (3) design visualization, (4) implement visualization, and (5) enable qualitative evaluation by domain experts. (3) Results: This study provides clinical insight into dementia based on EMR data via visual analysis. Results of a case study based on questionnaires surveying daily living activities indicated that daily behaviors influenced the progression of dementia. (4) Conclusions: This study provides a visual analytical tool to support cluster segmentation. Using this tool, we segmented dementia patients into clusters and interpreted the behavioral patterns of each group. This study contributes to biomedical data interpretation based on a visual approach.

Driving Cessation and Cognitive Dysfunction in Patients with Mild Cognitive Impairment

Although driving by adults with cognitive impairment is an important public health concern, little is known about the indicators of driving cessation in patients with mild cognitive impairment (MCI). We aimed to investigate the prevalence of driving cessation in patients with MCI and the predictive value of cognitive performances for driving cessation. Patients with MCI were recruited in the Seoul National University Bundang Hospital; they met following inclusion criteria. Age range of 51–80 years, Clinical Dementia Rating scale score of 0.5, and ever car drivers including former and current drivers. All participants underwent comprehensive standardized cognitive assessments and information on driving status was obtained via an interview using a systematic questionnaire. The median age of the 135 participants was 72 years, and 54 participants (40%) were women; 93 patients (68.9%) were current drivers and 42 (31.1%) were former drivers. In univariate analysis, former drivers showed poorer performances in digit span backward and categorical fluency tests than current drivers. In multivariate logistic regression analysis, a poor digit span backward test score was significantly related with driving cessation (odds ratio: 0.493, 95% confidence interval: 0.258–0.939). In patients with MCI, poor performance in the digit span backward test, which represents impaired working memory capacity, was associated with a higher probability of driving cessation.