Abstract for: Rising Burden of Vascular Cognitive Impairment in Singapore: Forecasting Disease Outcomes and Intervention Scenarios

The rising prevalence of vascular cognitive impairment (VCI) in aging populations poses a significant public health challenge. Current models fail to fully capture the complexity of VCI progression and the impact of interventions. This study seeks to develop a dynamic modeling framework to project the future burden of VCI in Singapore and evaluate the effectiveness of interventions, including the SINGER trial, aimed at preventing cognitive decline in older adults. This study uses longitudinal data from 700 participants in Singapore to develop a system dynamics model for Vascular Cognitive Impairment (VCI). The model will incorporate demographic trends, transition probabilities, vascular risk factors, healthcare utilisation, and disease progression. It aims to evaluate intervention strategies, including the SINGER trial and biomarkers, and assess cost-effectiveness using a dynamic framework implemented in Vensim and validated with expert inputs. The estimated transition probabilities highlight slow progression in the No Cognitive Impairment (NCI) state and limited reverse transitions in Alzheimer's and Vascular Dementia. The next steps include refining the conceptual framework, incorporating Singapore-specific data, validating the model in Vensim, and integrating cost-effectiveness and biomarker models. This integration will support policy evaluations, enabling comparisons of intervention strategies like SINGER and biomarker-based screening to inform cost-effective dementia care planning.