Multi-state Markov model in outcome of mild cognitive impairments among community elderly residents in Mainland China
Multi-state Markov model in outcome of mild cognitive impairments among community elderly residents in Mainland China
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中国大陆社区老年人轻度认知障碍结局的多状态马尔可夫模型
DOI：
10.1017/s1041610212002220
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发表时间：
2013-01
影响因子：
7
通讯作者：
Chengyi Qu
中科院分区：
文献类型：
--
作者：
Hongmei Yu;Shanshan Yang;Jianwei Gao;Liye Zhou;Ruifeng Liang;Chengyi Qu
摘要背景：虽然阿尔茨海默病（AD）的既定危险因素的知识可以在逻辑上有助于寻找认知障碍进展的预测因子，但尚未确定这些危险因素在认知障碍过程中发挥作用的位置以及如何定量预测轻度认知障碍（MCI）向AD的进展。本研究旨在确定已知的危险因素是否会增加从MCI进展为AD的风险，并根据转移概率进行预测。研究方法：基于对600名社区居住的MCI居民的10次检查和认知评估，将个体分类为MCI、整体损伤和AD，使用多状态马尔可夫考克斯回归模型，估计风险比及其置信区间和转移概率。结果如下：多变量分析显示，性别、年龄和高血压是从MCI转变为整体损害的统计学显著预测因素;年龄、教育和阅读对从整体损害转变为MCI具有统计学影响;性别、年龄、高血压、糖尿病和载脂蛋白E基因ε4状态与从整体损害转变为AD具有统计学相关性。MCI受试者在下一次认知评估时更有可能（67%）保持这种认知状态，而不是过渡到认知恶化。对于全局损伤，保持在相同状态的概率仅为18%，向前转移的概率是向后转移的概率的三倍。结论：已知的危险因素对不同的过渡期有不同的影响。从整体损害的过渡比从MCI的过渡更可能恶化为严重的认知恶化。
ABSTRACT Background: Although knowledge of established risk factors for Alzheimer's disease (AD) can logically contribute to the search for predictors of the progression of cognitive impairment, it has not yet been firmly established where in the cognitive impairment process these risk factors exert their effects and how to predict quantitatively for the progression of mild cognitive impairments (MCI) to AD. This study aimed to determine whether known risk factors increased the risk of progression from MCI to AD and to make prediction based on transition probabilities. Methods: Based on ten examinations of 600 community-dwelling MCI residents and cognitive assessments to classify individuals into MCI, global impairment, and AD, a multi-state Markov Cox's regression model was used and the hazard ratios with their confidence intervals and transition probabilities were estimated. Results: Multivariate analysis showed that gender, age, and hypertension were statistically significant predictors of transition from MCI to global impairment; age, education, and reading statistically influenced transition from global impairment to MCI; gender, age, hypertension, diabetes, and apolipoprotein E geneε4 status were statistically associated with transition from global impairment to AD. Subjects at MCI were more likely (67%) to remain in that cognitive state at the next cognitive assessment than to transition to cognitive deterioration. For global impairment, probability of remaining in the same state was only 18% and that of forward transition was three times more likely than that of backward transition. Conclusions: Known risk factors influenced differently for different transitions. Transition from global impairment was more likely to worsen to severe cognitive deterioration than transition from MCI.
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影响因子：
1.7
作者：
Ricardo Ocañ-Riola
通讯作者：
Ricardo Ocañ-Riola
影响因子：
48
作者：
Kalaria, Raj N.;Maestre, Gladys E.;Arizaga, Raul;Friedland, Robert P.;Galasko, Doug;Hall, Kathleen;Luchsinger, Jose A.;Ogunniyi, Adesola;Perry, Elaine K.;Potocnik, Felix;Prince, Martin;Stewart, Robert;Wimo, Anders;Zhang, Zhen-Xin;Antuono, Piero
通讯作者：
Antuono, Piero
影响因子：
--
作者：
Dickstein, Dara L.;Walsh, Jessica;Brautigam, Hannah;Stockton, Steven D., Jr.;Gandy, Samuel;Hof, Patrick R.
通讯作者：
Hof, Patrick R.
DOI：
10.1017/9781108587921.004
发表时间：
2008-11
期刊：
Language in Dementia
影响因子：
--
作者：
Li Qiang
通讯作者：
Li Qiang
DOI：
10.1097/00006199-197005000-00029
发表时间：
1969-09
期刊：
The Gerontologist
影响因子：
--
作者：
M. Lawton;E. Brody
通讯作者：
M. Lawton;E. Brody