Featured Article Predicting the progression of Alzheimer's disease dementia: A multidomain health policy model

Introduction: We develop a multidomain model to predict progression of Alzheimer’s disease dementia (AD). Methods: Data from the US National Alzheimer’s Coordinating Center (n 5 3009) are used to examine change in symptom status and to estimate transition probabilities between health states described using cognitive function, functional ability, and behavior. A model is used to predict progression and to assess a hypothetical treatment scenario that slows mild to moderate AD progression. Results: Morethan70%ofparticipantsmovedstateover12months.Themajoritymovedindomains other than cognitive function. Over 5 years, of those alive more than half are in severe AD health states. Assessing an intervention scenario, we see fewer years in more severe health states and a potential impact (life years saved) due to mortality improvements. Discussion: The model developed is exploratory and has limitations but illustrates the importance of using a multidomain approach when assessing impacts of AD and interventions. 2016 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).