{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:21:33Z","timestamp":1791411693222,"version":"4.3.3"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG062277"],"award-info":[{"award-number":["R01AG062277"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG024968"],"award-info":[{"award-number":["P30AG024968"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>A long-term projection model based on nationally representative data and tracking disease progression across Alzheimer\u2019s disease continuum is important for economics evaluation of Alzheimer\u2019s disease and other dementias (ADOD) therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The Health and Retirement Study (HRS) includes an adapted version of the Telephone Interview for Cognitive Status (TICS27) to evaluate respondents\u2019 cognitive function. We developed an ordered probit transition model to predict future TICS27 score. This transition model is utilized in the Future Elderly Model (FEM), a dynamic microsimulation model of health and health-related economic outcomes for the US population. We validated the FEM TICS27 model using a five-fold cross validation approach, by comparing 10-year (2006\u20132016) simulated outcomes against observed HRS data.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In aggregate, the distribution of TICS27 scores after ten years of FEM simulation matches the HRS. FEM\u2019s assignment of cognitive\/mortality status also matches those observed in HRS on the population level. At the individual level, the area under the receiver operating characteristic (AUROC) curve is 0.904 for prediction of dementia or dead with dementia in 10 years, the AUROC for predicting significant cognitive decline in two years for mild cognitive impairment patients is 0.722.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The FEM TICS27 model demonstrates its predictive accuracy for both two- and ten-year cognitive outcomes. Our cognition projection model is unique in its validation with an unbiased approach, resulting in a high-quality platform for assessing the burden of cognitive decline and translating the benefit of innovative therapies into long-term value to society.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0274417","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T17:50:51Z","timestamp":1663264251000},"page":"e0274417","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Using dynamic microsimulation to project cognitive function in the elderly population"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-783X","authenticated-orcid":true,"given":"Yifan","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4101-2492","authenticated-orcid":true,"given":"Hanke","family":"Heun-Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8497-3664","authenticated-orcid":true,"given":"Bryan","family":"Tysinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"issue":"3","key":"pone.0274417.ref001","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jalz.2019.01.010","volume":"15","author":"2019 Alzheimer\u2019s disease facts and figures","year":"2019","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"pone.0274417.ref002","first-page":"272","article-title":"Alzheimer\u2019s disease drug development pipeline: 2019.","volume":"5","author":"J Cummings","year":"2019","journal-title":"Alzheimer\u2019s & Dementia: Translational Research & Clinical Interventions"},{"key":"pone.0274417.ref003","article-title":"Approval of Aducanumab for Alzheimer Disease\u2014the FDA\u2019s Perspective.","author":"B Dunn","year":"2021","journal-title":"JAMA Internal Medicine."},{"issue":"s1","key":"pone.0274417.ref004","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.3233\/JAD-179905","article-title":"The End of the Beginning of the Alzheimer\u2019s Disease Nightmare: A Devil\u2019s Advocate\u2019s View.","volume":"64","author":"A. 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