Joint modeling for cognitive trajectory and risk of dementia in the presence of death.
Joint modeling for cognitive trajectory and risk of dementia in the presence of death.
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DOI：
10.1111/j.1541-0420.2009.01261.x
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发表时间：
2010-03
期刊：
影响因子：
1.9
通讯作者：
Ghosh P
中科院分区：
文献类型：
--
作者：
Yu B;Ghosh P
与正常衰老相比，痴呆症的特征在于诊断前后认知能力的加速下降。众所周知，认知障碍发生在痴呆症诊断之前很久。对于患有痴呆症的人来说，重要的是要确定认知下降速度开始加速的时间以及随后的痴呆症诊断间隔时间。对于正常衰老的个体，了解认知功能的轨迹直到他们死亡也是有用的。贝叶斯变点模型，提出了适合的个人发展痴呆症的认知功能的轨迹。在真实的生活中，老年人面临着两种相互竞争的风险，例如痴呆症和无痴呆症死亡。由于大多数人不会发展成痴呆症，因此将混合模型用于具有竞争风险的生存数据，其包括痴呆个体的认知功能下降的变化点之后的痴呆发作时间和非痴呆个体的死亡时间。认知轨迹和生存过程的联合建模和参数估计使用马尔可夫链蒙特卡罗方法。利用来自檀香山亚洲老龄化研究的数据，我们展示了认知功能的轨迹以及教育、载脂蛋白E 4基因型和高血压对认知能力下降和痴呆风险的影响。
Dementia is characterized by accelerated cognitive decline before and after diagnosis as compared to normal aging. It has been known that cognitive impairment occurs long before the diagnosis of dementia. For individuals who develop dementia, it is important to determine the time when the rate of cognitive decline begins to accelerate and the subsequent gap time to dementia diagnosis. For normal aging individuals, it is also useful to understand the trajectory of cognitive function until their death. A Bayesian change-point model is proposed to fit the trajectory of cognitive function for individuals who develop dementia. In real life, people in older ages are subject to two competing risks, e.g, dementia and dementia-free death. Because the majority of people do not develop dementia, a mixture model is used for survival data with competing risks, which consists of dementia onset time after the change-point of cognitive function decline for demented individuals and death time for non-demented individuals. The cognitive trajectories and the survival process are modeled jointly and the parameters are estimated using the Markov chain Monte Carlo method. Using data from the Honolulu Asia Aging Study, we show the trajectories of cognitive function and the effect of education, apolipoprotein E 4 genotype and hypertension on cognitive decline and the risk of dementia.
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影响因子：
9.9
作者：
Hall, C. B.;Derby, C.;Lipton, R. B.
通讯作者：
Lipton, R. B.
影响因子：
2
作者：
Hall, CB;Ying, J;Lipton, RB
通讯作者：
Lipton, RB
DOI：
10.1198/016214501753168145
发表时间：
2001-06-01
影响因子：
3.7
作者：
Skates, SJ;Pauler, DK;Jacobs, IJ
通讯作者：
Jacobs, IJ
影响因子：
2.7
作者：
HEIDELBERGER, P;WELCH, PD
通讯作者：
WELCH, PD
影响因子：
9.9
作者：
Wilson, RS;Beckett, LA;Bennett, DA
通讯作者：
Bennett, DA