Microstimulation models may help predict population-level dementia burden

Key takeaways:

• Primary preventive methods likely predict positive life-year impact on those who are cognitively normal.
• Larger effect sizes may lead to substantial impact on future dementia burden prediction models.

PHILADELPHIA — The creation of microstimulation models may help predict population-level dementia burdens by the year 2050; however, the success of the model is dependent on the size and quality of the data, according to a presenter.

“In the last couple of years, a lot of research has been conducted on the effects of dementia prevention before dementia onset,” Lynn van Rosmalen, MSc, from the department of public health at Erasmus Medical Center in Rotterdam, the Netherlands, told attendees at the Alzheimer’s Association International Conference.

Van Rosmalen and colleagues attempted to validate a microstimulation model — which charted the life course of millions of individuals with moderate to severe dementia and aggregated the extracted data — to quantitatively predict the change in life span and population-level dementia burden by 2050 after primary and secondary interventions were enacted.

Primary preventions were defined as measures aimed at decreasing risk factors prior to the onset of mild cognitive impairment (MCI) such as diet management and cardiovascular risk mitigation. Secondary measures were defined as pharmacological interventions aimed at slowing disease progression following the onset of cognitive impairment.

With primary prevention, the researchers assumed an effect size of 0.8 year of delay in the presymptomatic stage for those cognitively normal with an other-cause mortality shift of 1 year. For secondary prevention, the researchers assumed a multiplier of 1.1 for MCI and mild dementia duration in those with Alzheimer’s-related amyloid biomarkers.

Results from the model showed that primary prevention by the year 2050 would result in a net positive 3% change per 100,000 total life-years for those cognitively normal but would result in net negative changes for MCI, mild, moderate or severe dementia. Conversely, model results from secondary prevention predicted up to a 4% positive change per 100,000 life-years for those with MCI but a net negative (as high as 5% for moderate dementia) for all other variables.

“Current available interventions will only have a modest impact on population-level dementia burden,” van Rosmalen noted. “With larger effect sizes, interventions could have a substantial impact on future dementia burden.”