{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:01:31Z","timestamp":1790146891325,"version":"4.0.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Community dementia care involves interacting patients, caregivers, and formal care providers whose long-term dynamics are difficult to characterize with single-component empirical studies. We constructed and assessed a baseline agent-based model (ABM) to establish a transparent, inspectable reference scenario against which future computational experiments on organizational configurations can be evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A fully rule-based ABM of community dementia care was developed using prior empirical studies, published literature, policy documents, and structured expert consultation. Each rule and parameter was documented with its evidence source and population provenance. The formal baseline used 1,000 synthetic care units, 100 independent replications, a 60-month horizon, and all configuration switches at baseline values. Behavioral and psychological symptoms of dementia (BPSD) prevalence at initialization was aligned with a prespecified Chinese meta-analytic anchor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>BPSD prevalence increased from 75.6% at initialization to 96.4% at month 60 (Monte Carlo 95% CI, 96.3\u201396.5%). Mean caregiver burden rose from 0.505 to 0.782. By month 60, a mean of 161 care units were in institutional care. Scale and replication diagnostics confirmed numerical adequacy; local sensitivity analysis showed limited changes in primary outcomes across the tested range.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Under the documented formal baseline rules, the model generates conditional trajectories of disease progression, caregiver burden, closed-loop referral completion, and institutional-care membership. The resulting transparent baseline provides a comparison condition for future, explicitly scoped computational experiments on organizational configurations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1913457","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:17:45Z","timestamp":1790144265000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence-based construction and validation of an agent-based model of community integrated care for older adults living with dementia"],"prefix":"10.3389","volume":"14","author":[{"given":"Chenli","family":"Zhu","sequence":"first","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxuan","family":"Gao","sequence":"additional","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijin","family":"Li","sequence":"additional","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingjie","family":"Chang","sequence":"additional","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Shao","sequence":"additional","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Du","sequence":"additional","affiliation":[{"name":"School of General Practice and Continuing Education, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission","volume":"404","author":"Livingston","year":"2024","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e105","DOI":"10.1016\/S2468-2667(21)00249-8","article-title":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019","volume":"7","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref3","volume-title":"Global Action Plan on the Public Health Response to Dementia 2017\u20132025","year":"2017"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e010","DOI":"10.5334\/ijic.886","article-title":"Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care","volume":"13","author":"Valentijn","year":"2013","journal-title":"Int J Integr Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12877-025-05805-z","article-title":"Barriers for access and utilization of dementia care services in Europe: a systematic review","volume":"25","author":"Sorrentino","year":"2025","journal-title":"BMC Geriatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s12877-023-03756-x","article-title":"Exploring barriers to dementia screening and management services by general practitioners in China: a qualitative study using the COM-B model","volume":"23","author":"Gong","year":"2023","journal-title":"BMC Geriatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"5596","DOI":"10.1002\/alz.13348","article-title":"Preparedness of China\u2019s health care system to provide access to a disease-modifying Alzheimer\u2019s treatment","volume":"19","author":"Mattke","year":"2023","journal-title":"Alzheimers Dement"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"101174","DOI":"10.1016\/j.arr.2020.101174","article-title":"A research agenda for ageing in China in the 21st century (2nd edition)","volume":"64","author":"Fang","year":"2020","journal-title":"Ageing Res Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1016\/S0140-6736(22)01546-X","article-title":"The path to healthy ageing in China: a Peking University-Lancet Commission","volume":"400","author":"Chen","year":"2022","journal-title":"Lancet"},{"key":"ref10","volume-title":"National Action Plan for Addressing Dementia in Old Age (2024\u20132030)","year":"2024"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12874-019-0736-6","article-title":"Which design to evaluate complex interventions? Toward a methodological framework through a systematic review","volume":"19","author":"Minary","year":"2019","journal-title":"BMC Med Res Methodol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1146\/annurev-publhealth-040617-014317","article-title":"Agent-based modeling in public health: current applications and future directions","volume":"39","author":"Tracy","year":"2018","journal-title":"Annu Rev Public Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"16807","DOI":"10.3390\/ijerph192416807","article-title":"Agent-based modelling of health inequalities following the complexity turn in public health: a systematic review","volume":"19","author":"Boyd","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1002\/(SICI)1099-0526(199905\/06)4:5<41::AID-CPLX9>3.0.CO;2-F","article-title":"Agent-based computational models and generative social 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ecology","volume":"310","author":"Grimm","year":"2005","journal-title":"Science"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1093\/epirev\/mxab006","article-title":"Evolution and reproducibility of simulation modeling in epidemiology and health policy over half a century","volume":"43","author":"Jalali","year":"2021","journal-title":"Epidemiol Rev"},{"key":"ref28","doi-asserted-by":"crossref","DOI":"10.1145\/3586183.3606763","article-title":"Generative agents: interactive simulacra of human behavior","author":"Park","year":"2023"},{"key":"ref29","author":"Taillandier","year":"2025"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1162\/coli_a_00502","article-title":"Can large language models transform computational social science?","volume":"50","author":"Ziems","year":"2024","journal-title":"Comput 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