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Development and validation of the Michigan Chronic Disease Simulation Model (MICROSIM)
James F Burke1, Luciana L Copeland2, Jeremy B Sussman3,4,5
1Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America.
Plos One
|May 16, 2024
Summary
Managing blood pressure (BP) across a lifetime may help prevent Alzheimer's disease and related dementias (AD/ADRD). A new simulation model, MICROSIM, can now estimate the population-level impact of BP control on both dementia and cardiovascular disease.
Area of Science:
- Gerontology
- Epidemiology
- Computational Biology
Background:
- Alzheimer's disease and related dementias (AD/ADRD) pose a significant public health challenge, necessitating effective prevention strategies.
- Blood pressure (BP) management is a promising avenue for delaying or preventing AD/ADRD, but its long-term effects across the life course remain unclear.
- Existing simulation models lack the capability to assess the combined impact of BP control on both dementia and cardiovascular disease outcomes.
Purpose of the Study:
- To introduce and validate a novel population-health microsimulation framework, MICROSIM (MIchigan ChROnic Disease SIMulation).
- To enable the estimation of population-level effects of various BP management strategies on dementia and cardiovascular disease.
- To support the "Effect of Lower Blood Pressure over the Life Course on Late-life Cognition in Blacks, Hispanics, and Whites" (BP-COG) study.
Main Methods:
- Developed MICROSIM as an agent-based Monte Carlo simulation framework using best programming practices.
- Utilized National Health and Nutrition Examination Survey (NHANES) data for a nationally representative US adult sample (18+).
- Incorporated data from 6 US prospective cardiovascular cohort studies to model risk factors, cognition, and dementia transitions; BP treatment effects derived from meta-analyses.
Main Results:
- MICROSIM successfully reproduces US population-level estimates for BP, vascular risk factors, and their changes over time.
- The framework accurately models incident all-cause dementia, stroke, myocardial infarction, and mortality.
- Validated population-level estimates for key health outcomes, demonstrating the model's reliability.
Conclusions:
- MICROSIM is a validated, extensible, open-source simulation framework for assessing the population-level impact of BP management strategies.
- This novel tool can now estimate the effects of BP control on both dementia and cardiovascular disease across the life course.
- MICROSIM provides a practical approach to inform public health policies aimed at preventing AD/ADRD and cardiovascular diseases.
