Using The Apriori Algorithm To Classify The Care Needs Of Patients With Different Types Of Dementia

Figures & data

Table 1 Fifteen Care Needs Addressed By Changhua Christian Hospital

Number	Description	Contents
1	Adequate nutrition and diet	This need was selected if the nutritional assessment was abnormal through evaluating a patient’s oral intake ability and recent body weight change. A nursing case manager or dietician gave individualized nutritional suggestions
2	Maintenance of personal hygiene	This need was chosen if a patient’s activity of daily living was impaired. Care skills education and in-house reablement program were introduced
3	Appropriate schedule of activities	This need was targeted if a patient’s daily physical activity was low. A nursing case manager would provide a daily schedule suggestion
4	Adequate sleep and rest	This need was selected if poor sleep quality was recorded. The study team then provided sleep hygiene education and discussed the usage of sleep medication
5	Fall prevention	This need was added if a risk of fall score located within a high-risk group. Physical training program and assistive devices evaluation were introduced
6	Preventing traffic accidents and getting lost	This need was chosen if a patient’s ambulatory function was preserved with the history of traffic accident or getting lost due to a cognitive decline. A nursing case manager then provided the driving ability evaluation and assistive device for prevention of getting lost
7	Preventing misusage of medications	This need was selected if misusage of medication was detected through asking residual drugs or from the care partner. Strategies including using drug boxes and decreasing use frequency were suggested
8	Adjusting home environment safety	This need was selected if any event of indoor safety concern has been recorded (eg, overcooked or burning). An experienced nurse or therapist then provided home environmental evaluation and adjustment
9	Regular outpatient follow-up treatment	This need was added if a physician suggested a medication treatment. A case manager would follow the patient every month to maintain adherence
10	Behavioral and psychological symptoms of dementia (BPSD) treatment	This need was selected if presence of any BPSD, which was detected through neuropsychiatric inventory annually. Non-pharmacological treatments were given first and pharmacological interventions were only reserved for severe patients
11	Referral to other specialists	This need was added if any medical problem which needs other subspecialists was detected during the assessment
12	Introduction and referral of social resources	This need was selected if PLWD and their caregivers asked social resources such as disability card, day care facilities, or guardianship
13	Referral to family support groups and care skills training	This need was chosen if a high Zarit’s caregiver burden score was recorded during the assessment. Support groups of dementia caregivers were introduced
14	Care for the mood of the caregiver	This need was selected if a caregiver presented with depressive mood (screen by CES-D). The caregiver with the severe condition received emotional support and transferred to psychiatrist
15	Education for dementia and BPSD	This need was chosen if PLWD and caregivers asked education information about dementia or BPSD, such as prevention, disease course, and medications. Different education programs were arranged according to the learning ability

Abbreviation: CES-D, Center for Epidemiologic Studies-Depression Scale.

Table 2 Information Of The Patients With Dementia

Variables		Frequency	Percentage	Data Type
Gender	Male	175	34	M
	Female	333	66	F
Age	Less than 65 years old	17	3	0
	65–69 years old	20	4	1
	70–74 years old	56	11	2
	75–79 years old	147	29	3
	80–84 years old	145	29	4
	85 years old and above	123	24	5
Type of dementia	Alzheimer’s disease	363	72	AD
	Parkinson’s disease	26	5	PDD
	Vascular dementia	93	18	VaD
	Mixed dementia	26	5	MD
CDR	Very mild dementia	104	21	0
	Mild dementia	260	51	1
	Moderate dementia	89	18	2
	Severe dementia	55	11	3

Abbreviation: CDR, clinical dementia rating.

Table 3 Information Of The Patients With Dementia

Rule No.	Antecedent	Consequent	No. Of CasesIn The Database	Support (%)	Confidence (%)	Lift
1	Age = 2	Care (15) = 1	56	11.02	98.21	1.04
2	Care (7) = 1	Care (15) = 1	66	12.99	98.49	1.04
3	Care (7) = 1	Care (12) = 1	51	10.04	90.20	1.12
	Type = AD
4	CDR = 2	Care (15) = 1	51	10.04	96.08	1.01
	Care (5) = 1
5	Care (7) = 1	Care (15) = 1	51	10.04	100.00	1.05
	Care (12) = 1
	Care (9) = 1
6	Care (13) = 1	Care (9) = 1	272	53.54	91.54	1.04
	Care (12) = 1
	Care (3) = 1
	Care (15) = 1

Table 4 Three Generalized Rules With Support Of 20% But Less Than 30%

Rule	Antecedent	Consequent	No. Of Cases In The Database	Support (%)	Confidence (%)	Lift
1	Care (6) = 1	Care (15) = 1	108	21.26	98.15	1.03
	Type = AD
	Care (9) = 1
	Care (6) = 1	Care (15) = 1	121	23.82	96.69	1.02
	Type = AD
	Care (6) = 1	Care (15) = 1	113	22.24	96.46	1.02
	Type = AD
	Care (12) = 1
	Care (6) = 1	Care (12) = 1	121	23.82	93.39	1.16
	Type = AD
	Care (6) = 1	Care (12) = 1	117	23.03	93.16	1.15
	Type = AD
	Care (15) = 1
	Care (6) = 1	Care (12) = 1	108	21.26	92.59	1.15
	Type = AD
	Care (9) = 1
	Care (6) = 1	Care (12) = 1	106	20.87	92.45	1.15
	Type = AD
	Care (9) = 1
	Care (15) = 1
	Care (6) = 1	Care (9) = 1	117	23.03	90.60	1.03
	Type = AD
	Care (15) = 1
2	Care (5) = 1	Care (15) = 1	114	22.44	96.49	1.02
	Type = AD
	Care (3) = 1
	Care (5) = 1	Care (15) = 1	113	22.24	96.46	1.02
	Type = AD
	Care (9) = 1
	Care (5) = 1	Care (15) = 1	130	25.59	96.15	1.01
	Type = AD
	Care (5) = 1	Care (9) = 1	104	20.47	90.39	1.03
	Type = AD
	Care (12) = 1
3	Care (5) = 1	Care (15) = 1	111	21.85	96.40	1.02
	CDR = 1
	Care (5) = 1	Care (15) = 1	102	20.08	96.08	1.01
	CDR = 1
	Care (9) = 1
	Care (5) = 1	Care (9) = 1	111	21.85	91.89	1.04
	CDR = 1
	Care (5) = 1	Care (9) = 1	107	21.06	91.59	1.04
	CDR = 1
	Care (15) = 1

Table 5 Nine Generalized Rules With The Support Of 10% But Less Than 20%

Rule	Antecedent	Consequent	No. Of Cases In The Database	Support (%)	Confidence (%)	Lift
1	Type = VaD	Care (15) = 1	70	13.780	95.71	1.01
	Care (12) = 1
	Type = VaD	Care (15) = 1	52	10.24	98.08	1.03
	Care (12) = 1
	Care (3) = 1
	Type = VaD	Care (15) = 1	62	12.21	96.77	1.02
	Care (12) = 1
	Care (9) = 1
	Type = VaD	Care (15) = 1	60	11.81	95.00	1.01
	Care (13) = 1
	Care (12) = 1
	Type = VaD	Care (9) = 1	60	11.81	91.67	1.04
	Care (13) = 1
	Care (12) = 1
	Type = VaD	Care (9) = 1	57	11.22	92.98	1.05
	Care (13) = 1
	Care (12) = 1
	Care (15) = 1
	Type = VaD	Care (15) = 1	55	10.83	96.36	1.02
	Care (13) = 1
	Care (12) = 1
	Care (9) = 1
	Type = VaD	Care (9) = 1	64	12.60	90.63	1.03
	Care (13) = 1
	Care (15) = 1
	Type = VaD	Care (12) = 1	58	11.42	91.38	1.13
	Care (13) = 1
	Care (9) = 1
	Care (15) = 1
	Type = VaD	Care (15) = 1	65	12.80	96.92	1.02
	Care (3) = 1
	Type = VaD	Care (15) = 1	58	11.42	96.55	1.02
	Care (3) = 1
	Care (9) = 1
	Type = VaD	Care (9) = 1	51	10.04	92.16	1.05
	Care (5) = 1
2	CDR = 2	Care (15) = 1	57	11.22	96.49	1.02
	Type = AD
	Care (9) = 1
	CDR = 2	Care (15) = 1	57	11.22	98.25	1.04
	Type = AD
	Care (3) = 1
	CDR = 2	Care (15) = 1	55	10.83	96.36	1.02
	Type = AD
	Care (12) = 1
	CDR = 2	Care (15) = 1	66	12.99	96.97	1.02
	Type = AD
3	Age = 3 Gender = F	Care (15) = 1	60	11.81	100	1.05
	Type = AD
	Care (12) = 1
	Care (3) = 1
	Age = 3	Care (15) = 1	70	13.78	100	1.05
	Gender = F
	Type = AD
	Care (12) = 1
	Care (9) = 1
	Age = 3	Care (15) = 1	64	12.60	100	1.05
	Gender = F
	Type = AD
	Care (13) = 1
	Care (12) = 1
	Age = 3	Care (15) = 1	55	10.83	100	1.05
	Gender = F
	Type = AD
	Care (13) = 1
	Care (3) = 1
	Age = 3	Care (15) = 1	64	12.60	100	1.05
	Gender = F
	Type = AD
	Care (13) = 1
	Care (9) = 1
4	CDR = 2	Care (15) = 1	51	10.04	96.08	1.01
	Care (5) = 1
	CDR = 2	Care (9) = 1	51	10.04	90.20	1.02
	Care (5) = 1
5	CDR = 2	Care (9) = 1	53	10.43	90.57	1.03
	Gender = F
	Care (15) = 1
	CDR = 2	Care (15) = 1	54	10.63	98.15	1.03
	Gender = F
	CDR = 2	Care (9) = 1	54	10.63	90.74	1.03
	Gender = F
6	Age = 3	Care (15) = 1	64	12.60	100	1.05
	Gender = F
	Care (12) = 1
	Care (3) = 1
	Care (9) = 1
	Age = 3	Care (15) = 1	61	12.01	100	1.05
	Gender = F
	Care (13) = 1
	Care (3) = 1
	Care (9) = 1
7	Age = 3	Care (15) = 1	78	15.35	100	1.05
	Care (13) = 1
	Care (12) = 1 Care (3) = 1
	Care (9) = 1
	Age = 3	Care (15) = 1	85	16.73	100	1.05
	Care (13) = 1
	Care (3) = 1
	Care (9) = 1
	Age = 3	Care (15) = 1	51	10.04	100	1.05
	Care (14) = 1
	Care (13) = 1
	Care (3) = 1
	Age = 3	Care (15) = 1	62	12.21	100	1.05
	Care (14) = 1
	Care (3) = 1
	Age = 3	Care (15) = 1	54	10.63	100	1.05
	Care (14) = 1
	Care (3) = 1
	Care (9) = 1
	Age = 3	Care (15) = 1	53	10.43	100	1.05
	Care (14) = 1
	Type = AD
	Care (9) = 1
8	Age = 4	Care (15) = 1	63	12.40	100	1.05
	CDR = 1
	Care (13) = 1
	Age = 4	Care (15) = 1	55	10.83	100	1.05
	CDR = 1
	Care (13) = 1
	Care (12) = 1
	Age = 4	Care (15) = 1	51	10.04	100	1.05
	CDR = 1
	Care (13) = 1
	Care (12) = 1
	Care (3) = 1
	Age = 4	Care (15) = 1	57	11.22	100	1.05
	CDR = 1
	Care (13) = 1
	Care (3) = 1
	Age = 4	Care (15) = 1	53	10.43	100	1.05
	CDR = 1
	Care (13) = 1
	Care (3) = 1
	Care (9) = 1
	Age = 4	Care (15) = 1	58	11.42	100	1.05
	CDR = 1
	Care (13) = 1
	Care (9) = 1
	Age = 4	Care (15) = 1	57	11.22	100	1.05
	Care (5) = 1
	Care (3) = 1
9	Care (8) = 1	Care (15) = 1	97	19.09	100	1.05
	Care (12) = 1
	Care (3) = 1
	Care (9) = 1
	Care (8) = 1	Care (15) = 1	90	17.72	100	1.05
	Care (13) = 1
	Care (12) = 1
	Care (3) = 1
	Care (8) = 1	Care (15) = 1	80	15.75	100	1.05
	Care (13) = 1
	Care (12) = 1
	Care (3) = 1
	Care (9) = 1
	Care (8) = 1	Care (15) = 1	56	11.02	100	1.05
	Care (14) = 1
	Care (12) = 1
	Care (3) = 1
	Care (8) = 1	Care (15) = 1	59	11.61	100	1.05
	Care (14) = 1
	Care (3) = 1
	Care (9) = 1
	Care (6) = 1	Care (15) = 1	52	10.24	100	1.05
	Care (8) = 1
	Care (12) = 1
	Care (3) = 1
	Care (6) = 1	Care (15) = 1	51	10.04	100	1.05
	Care (8) = 1
	Care (12) = 1
	Care (3) = 1
	Care (9) = 1
	Care (6) = 1	Care (15) = 1	59	11.61	100	1.05
	Care (8) = 1
	Care (12) = 1
	Care (9) = 1
	Care (6) = 1	Care (15) = 1	51	10.04	100	1.05
	Care (8) = 1
	Care (13) = 1
	Care (12) = 1
	Care (6) = 1	Care (15) = 1	57	11.22	100	1.05
	Care (8) = 1
	Care (3) = 1
Care (9) = 1