# The CHARMED model: a multimorbidity simulation model for people aging with HIV

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $26,898

## Abstract

PROJECT SUMMARY
Almost half of all people diagnosed with HIV in the United States are aged 50 or older, and they are at
increased risk for dementia and multimorbidity. Dementia is of major clinical policy concern because it results
in both inexorable clinical decline and extremely high costs of care. People with HIV are at particularly high risk
because they often have major risk factors for the development of traditional etiologies of dementia, such as
Alzheimer's Disease and Alzheimer's Disease-Related Dementias (AD/ADRD), and they also have a risk of
HIV-associated neurocognitive disease (HAND) despite sustained virologic suppression. Depression,
cardiovascular disease (CVD), and HIV are known to have potent synergies that contribute to the development
of dementia. These comorbidities are modifiable risk factors for dementia that are highly prevalent, known to
be undertreated in people with HIV, and likely to be clinically and economically important targets for prevention
and management.
The overall goal of this proposal is to provide an evidence-based approach for prioritizing and advocating for
interventions to improve the quality of life and reduce morbidity and mortality among people aging with HIV.
The benefits of reducing the burden of depression and CVD among people with HIV may currently be
underestimated, given that concomitant benefits related to multimorbidity are often not captured due to short
durations of observational or trial data. Determining which interventions are most clinically effective and cost-
effective is critically important to understand so that people aging with HIV can benefit from strategies to
reduce their risk of dementia and multimorbidity as they age. We propose to: 1) develop the Cognitive
impairment, HIV, Aging, heaRt, MEntal health, and Dementia (CHARMED) Model, including populating the
model with clinical and outcomes data from the North American AIDS Cohort Collaboration on Research and
Design (NA-ACCORD) and nationally-representative cost data; 2) project clinical and economic outcomes of
people aging with HIV; and 3) perform cost-effectiveness analyses of targeted interventions to reduce the
burden of depression and CVD and to quantify the resultant reduction in dementia and multimorbidity.
This proposal comprises a unique collaboration of experts in methods that are complementary and essential to
complete the research aims: clinical expertise, epidemiology of people aging with HIV, costing, simulation
modeling, and cost-effectiveness analysis. The proposed innovative multimorbidity model will be the first to
include these important comorbidities that are highly prevalent, demonstrate synergies that contribute to
dementia, and are amenable to treatment. The model structure and parameterization can both be revised with
the emergence of updated data and improved understanding of the synergies and pathophysiology. This
simulation modeling approach will allow for analyses of clinical and policy questions t...

## Key facts

- **NIH application ID:** 11084931
- **Project number:** 3R01AG069575-04S1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Emily Parker Hyle
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $26,898
- **Award type:** 3
- **Project period:** 2021-04-01 → 2024-06-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11084931

## Citation

> US National Institutes of Health, RePORTER application 11084931, The CHARMED model: a multimorbidity simulation model for people aging with HIV (3R01AG069575-04S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11084931. Licensed CC0.

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