Year: 2024
Type: article
Abstract: Strategies to prevent or delay Alzheimer's disease and related dementias (AD/ADRD) are urgently needed, and blood pressure (BP) management is a promising strategy. Yet the effects of different BP control strategies across the life course on AD/ADRD are unknown. Randomized trials may be infeasible due to prolonged follow-up and large sample sizes. Simulation analysis is a practical approach to estimating these effects using the best available existing data. However, existing simulation frameworks cannot estimate the effects of BP control on both dementia and cardiovascular disease. This manuscript describes the design principles, implementation details, and population-level validation of a novel population-health microsimulation framework, the MIchigan ChROnic Disease SIMulation (MICROSIM), for The Effect of Lower Blood Pressure over the Life Course on Late-life Cognition in Blacks, Hispanics, and Whites (BP-COG) study of the effect of BP levels over the life course on dementia and cardiovascular disease. MICROSIM is an agent-based Monte Carlo simulation designed using computer programming best practices. MICROSIM estimates annual vascular risk factor levels and transition probabilities in all-cause dementia, stroke, myocardial infarction, and mortality in a nationally representative sample of US adults 18+ using the National Health and Nutrition Examination Survey (NHANES). MICROSIM models changes in risk factors over time, cognition and dementia using changes from a pooled dataset of individual participant data from 6 US prospective cardiovascular cohort studies. Cardiovascular risks were estimated using a widely used risk model and BP treatment effects were derived from meta-analyses of randomized trials. MICROSIM is an extensible, open-source framework designed to estimate the population-level impact of different BP management strategies and reproduces US population-level estimates of BP and other vascular risk factors levels, their change over time, and incident all-cause dementia, stroke, myocardial infarction, and mortality.
Source: PLoS ONE
Authors: James F. Burke, Luciana L. Copeland, Jeremy B. Sussman, Rodney A. Hayward, Alden L. Gross, Emily M. Briceño, Rachael Whitney, Bruno J. Giordani, Mitchell S. V. Elkind, Jennifer J. Manly, Rebecca F. Gottesman, Darrell J. Gaskin, Stephen Sidney, Kristine Yaffe, Ralph L. Sacco, Susan R. Heckbert, Timothy M. Hughes, Andrzej T. Galecki, Deborah A. Levine
Institutions: The Ohio State University Wexner Medical Center, University of Michigan, VA Center for Clinical Management Research, Johns Hopkins University, Columbia University, National Institute of Neurological Disorders and Stroke, Kaiser Permanente, Kaiser Permanente Northern California, University of California, San Francisco, University of Miami, University of Washington, Wake Forest University Health Sciences, Wake Forest University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,290
Funders: U.S. Department of Health and Human Services, Northwestern University, University of Minnesota, National Institutes of Health, Kaiser Foundation Research Institute, Gillings School of Public Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Center for Advancing Translational Sciences
Awards: G1023702118, The Macrovascular and Microvascular Contributions to Alzheimer's Disease: MESA VASCAD, G1097528416, G1114307781, G1201667161, G1220223050, G1220445869, G125109066, G1261314546, G1262629770, MESA, CORONARY HEART DISEASE AND STROKE, G128745896, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, Michigan Alzheimer's Disease Core Center, G1304508731, G1338207769, G1359416556, G1401438683, G1409423729, G1438302022, G1443812313, G1522370804, G1539384734, Lifecourse CVD Risk and Midlife Cognitive Trajectories and Brain Aging: Implications for Alzheimer's and Dementia Prevention, G1589692941, CORONARY HEART DISEASE AND STROKE, G1649448277, G165438358, G1670764805, G1686417863, G1788514665, G1803853571, G1823732541, G1844203612, G1886881331, G190379715, G1942032999, G19438214, G2079069761, G2117773213, G2143491823, G2194386449, G2195207551, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G2262505034, G2262782284, G228913406, The ARIC-PET Amyloid Imaging Study, G2383388692, G2391884931, MESA, G247538147, G2555427744, G2568281471, G2580996367, G2607172802, CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G2701926366, G278200998, MESA, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--EBCT READING, G293741327, G3031150197, G3045517347, G3137375862, Atrial fibrillation burden, vascular disease of the brain and cardiac MRI in MESA, G3220743633, G322252321, G3223614423, G3248120388, G3256118428, G3329506677, G3405256882, G34347772, G3489222679, CHS research resources for the cardiovascular health of older adults, G3541419165, G3570589137, G3647016462, G3685010094, G3687594596, G3744596180, G379612770, MESA, G3826263370, G3853170735, G3901643820, G3935527841, G394051101, G3973572274, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, G399481048, Predictors of Alheimers Disease in Mild Cognitive Impairment, G4068323944, G4219624527, G4230684217, G423252844, G429397448, TITLE: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), G4512137732, G4563812999, G4597579782, G4622379297, ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5, G4714600099, G4739409156, G4747441672, G4790942633, G4845182219, OPTION 3. 4/1/2014 - 3/31/2015. MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - READING CENTER, NHLBI, MESA, ARIC Neurocognitive Study (ARIC-NCS) Renewal 4 of 5, G5023962947, G5088122703, G5108002584, G514410172, G5148796768, G517941596, G5185723337, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUND, G5251985303, G5352314984, G5364873420, G5450057682, G5464419710, G5479317095, G5556898879, G5622883882, G5770678025, G5787256936, G581887176, G583528397, G5908135296, G5928944960, G5981726443, G5999060983, CHS Events Follow-up Study, G6060132884, Decision Making for Cardiovascular Therapy in Adults with Mild Cognitive Impairment, G6095866717, G6182174406, G6226795708, G6322445267, G6359107525, Institute for Clinical and Translational Research, MESA, G6483657930, G6514094751, G6594067713, G666720426, G6739173425, ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5, ARIC Neurocognitive Study (ARIC-NCS), G6837735701, G6863459535, G706815212, G7132376052, G7155745631, G7176672723, G7217924807, MESA, G739565590, G7535686976, G766700449, G7799800877, G7806539067, G7808459314, G8018240826, G806768229, G8068269535, Clinical and Translational Science Award, G814392139, G8260701975, G836417160, G84345693, COGNITIVE TESTS, APOE, BRAIN MRI AND RISKS OF DEMENTIA, G8518686724, CHS-Transition Phase -268055222, G8738262636, G8761005068, G8892155751, G8976278160, G899128061, G9000038488, G9000043932, G9000046851, G9000069887, G9000071824, G9000087181, G9000087953, G9000124008, G9000149183, G9000155215, G9000165945, G9000218452, Michigan Center for Diabetes Translational Research, ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028, Measurement of cognition and functional decline in Latinx older adults for detection of Alzheimer’s Disease and Related Dementias: A mixed-methods approach, G901665369, G905887895, G94668252, G979295734
OpenAlex ID: W4396949155