Yu Lei, Tyas Suzanne L, Snowdon David A, Kryscio Richard J
Department of Statistics, University of Kentucky.
Comput Stat Data Anal. 2009 Jul 1;53(9):3334-3343. doi: 10.1016/j.csda.2009.02.007.
This paper evaluates the effect of ignoring baseline when modeling transitions from intact cognition to dementia with mild cognitive impairment (MCI) and global impairment (GI) as intervening cognitive states. Transitions among states are modeled by a discrete-time Markov chain having three transient (intact cognition, MCI, and GI) and two competing absorbing states (death and dementia). Transition probabilities depend on two covariates, age and the presence/absence of an apolipoprotein E-epsilon4 allele, through a multinomial logistic model with shared random effects. Results are illustrated with an application to the Nun Study, a cohort of 678 participants 75+ years of age at baseline and followed longitudinally with up to ten cognitive assessments per nun.
本文评估了在将从完整认知到痴呆的转变建模时忽略基线的影响,其中将轻度认知障碍(MCI)和整体损害(GI)作为中间认知状态。状态之间的转变通过具有三个瞬态状态(完整认知、MCI和GI)和两个竞争吸收状态(死亡和痴呆)的离散时间马尔可夫链进行建模。转变概率通过具有共享随机效应的多项逻辑模型依赖于两个协变量,即年龄和载脂蛋白E-ε4等位基因的有无。通过对修女研究的应用来说明结果,该研究队列在基线时为678名75岁及以上的参与者,每位修女纵向随访多达十次认知评估。