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

ABSTRACT: We develop a multidomain model to predict progression of Alzheimer's disease dementia (AD).Data from the US National Alzheimer's Coordinating Center (n = 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.More than 70% of participants moved state over 12 months. The majority moved in domains 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.The model developed is exploratory and has limitations but illustrates the importance of using a multidomain approach when assessing impacts of AD and interventions.

SUBMITTER: Green C

PROVIDER: S-EPMC5104191 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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

Green Colin C Zhang Shenqiu S

Alzheimer's & dementia : the journal of the Alzheimer's Association 20160324 7

<h4>Introduction</h4>We develop a multidomain model to predict progression of Alzheimer's disease dementia (AD).<h4>Methods</h4>Data from the US National Alzheimer's Coordinating Center (n = 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 progres ...[more]

PMID: 27016691

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Project description:Early identification of individuals at risk of developing Alzheimer's disease (AD) dementia is important for developing disease-modifying therapies. In this study, given multimodal AD markers and clinical diagnosis of an individual from one or more timepoints, we seek to predict the clinical diagnosis, cognition and ventricular volume of the individual for every month (indefinitely) into the future. We proposed and applied a minimal recurrent neural network (minimalRNN) model to data from The Alzheimer's Disease Prediction Of Longitudinal Evolution (TADPOLE) challenge, comprising longitudinal data of 1677 participants (Marinescu et al., 2018) from the Alzheimer's Disease Neuroimaging Initiative (ADNI). We compared the performance of the minimalRNN model and four baseline algorithms up to 6 years into the future. Most previous work on predicting AD progression ignore the issue of missing data, which is a prevalent issue in longitudinal data. Here, we explored three different strategies to handle missing data. Two of the strategies treated the missing data as a "preprocessing" issue, by imputing the missing data using the previous timepoint ("forward filling") or linear interpolation ("linear filling). The third strategy utilized the minimalRNN model itself to fill in the missing data both during training and testing ("model filling"). Our analyses suggest that the minimalRNN with "model filling" compared favorably with baseline algorithms, including support vector machine/regression, linear state space (LSS) model, and long short-term memory (LSTM) model. Importantly, although the training procedure utilized longitudinal data, we found that the trained minimalRNN model exhibited similar performance, when using only 1 input timepoint or 4 input timepoints, suggesting that our approach might work well with just cross-sectional data. An earlier version of our approach was ranked 5th (out of 53 entries) in the TADPOLE challenge in 2019. The current approach is ranked 2nd out of 63 entries as of June 3rd, 2020.

Dataset Information

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

Publications

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

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