Qin Yao, Cui Jing, Chen Durong, Han Hongjuan, Cao Hongyan, Zhang Rong, Zhu Hao, Zhang Meiling, Yu Hongmei
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, Shanxi, China.
Alzheimers Dement. 2025 May;21(5):e70263. doi: 10.1002/alz.70263.
Characterizing transitions of cognitive state, including reversion from mild cognitive impairment (MCI) to normal cognition (NC) and subsequent cognitive stability or deterioration for post-reversion, has so far remained limited.
Using a retrospective cohort of subjects with an MCI diagnosis at study entry and at least two follow-up visits between 2005 and December 2022, we developed a functional multistate model framework to estimate longitudinal patterns of transition probabilities between different cognitive states.
The probability of reversion increased from 2% at baseline to a maximum of 8% by year 10 before gradual decline thereafter. For post-reversion, the probability of progression to MCI rose from 8% to 35.71% at Year 10 and subsequently stabilized.
The instantaneous risk of MCI progressing was similar to the risk of re-progression to MCI for post-reversion. Post-reversion subjects remained at an increased risk of cognitive deterioration.
The instantaneous risk of MCI progressing to AD is similar to the risk of re-progression to MCI for post-reversion. The FMSM we developed effectively utilizes multiple longitudinal markers to reveal variable transition patterns between different cognitive states. Considering both spatiotemporal dimensions and sparse irregularities from longitudinal neuroimaging and neuropsychological scales, fMLFPCA and MVFPCA help to extract variation patterns, to capture detailed changes characterizing the multidimensional evolution patterns of MCI.
认知状态转变的特征描述，包括从轻度认知障碍（MCI）恢复到正常认知（NC）以及恢复后随后的认知稳定性或衰退情况，目前仍然有限。
我们使用了一个回顾性队列，这些受试者在研究开始时被诊断为MCI，并且在2005年至2022年12月期间至少有两次随访。我们开发了一个功能多状态模型框架，以估计不同认知状态之间转变概率的纵向模式。
恢复的概率从基线时的2%增加到第10年时的最高8%，此后逐渐下降。对于恢复后，进展为MCI的概率在第10年从8%上升到35.71%，随后稳定下来。
MCI进展的即时风险与恢复后再次进展为MCI的风险相似。恢复后的受试者认知衰退风险仍然增加。
MCI进展为AD的即时风险与恢复后再次进展为MCI的风险相似。我们开发的功能多状态模型有效地利用了多个纵向标记，以揭示不同认知状态之间的可变转变模式。考虑到纵向神经影像学和神经心理学量表的时空维度以及稀疏不规则性，功能多变量局部主成分分析（fMLFPCA）和多变量功能主成分分析（MVFPCA）有助于提取变化模式，以捕捉表征MCI多维演变模式的详细变化。
