Microsimulation modeling to support behavioral interventions in AD/ADRD for patients and their caregivers

摘要 罗伊巴尔老龄行为干预中心的总体目的是加强 世界各地的临床医生都有能力推荐最安全、最有效的治疗方法 他们的病人通过行为经济干预。该中心的具体目标是： (1)开展行为干预开发和实施，鼓励适当 通过使用心理学和心理学的行为洞察力做出医疗决策 经济学；(2)为选择影响潜力最大的干预措施提供信息 通过使用模拟模型，以及(3)将这些发现转化为政策 影响老龄化政策的制定者。拟议的补充资金将支持杠杆化 并扩展未来老年人模型对阿尔茨海默氏症影响的建模能力 患者及其照顾者的疾病和相关痴呆症，以确定 最大的潜在影响。这反过来又会影响到 有针对性的行为干预。建议的建模扩展扩展了 行为、认知和功能领域，结合了痴呆症的分期，并改善了 生活质量评估的方法。改进了护理者建模，以更好地反映护理 工作时间和生活质量的影响。然后，该建模框架允许识别 高价值的干预领域，无论是朝着遵循最佳处方做法的方向发展， 管理特定的患者症状，针对面临最高质量的特定人群- 生活负担，或改善对照顾者的支持。

ABSTRACT The overall purpose of the Roybal Center for Behavioral Interventions in Aging is to strengthen the ability of clinicians everywhere to recommend the safest and most effective treatments for their patients through behavioral economic interventions. The specific aims of the Center are to: (1) Conduct behavioral intervention development and implementation to encourage appropriate medical treatment decisions through the use of behavioral insights from psychology and economics; (2) Inform the selection of these interventions with the greatest potential to impact population health through the use of simulation models, and (3) Translate these findings for policy makers who influence aging policy. The proposed supplemental funding will support leveraging and extending the Future Elderly Model's capabilities for modeling the impact of Alzheimer's disease and related dementias for both patients and their caregivers, in order to identify areas of greatest potential impact. This, in turn, could influence the development and implementation of targeted behavioral interventions. The proposed modeling expansion extends the modeling of behavioral, cognitive, and functional domains, incorporates staging of dementia, and improves the approach to quality of life assessment. Caregiver modeling is enhanced to better reflect care hours and quality of life impacts. This modeling framework then allows for the identification of high-value areas for intervention, be they nudging towards following best practices for prescribing, managing particular patient symptoms, targeting particular populations facing the highest quality- of-life burden, or improving support for caregivers.