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首页> 外文期刊>Annals of epidemiology >A Multistate Model of Cognitive Dynamics in Relation to Frailty in Older Adults
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A Multistate Model of Cognitive Dynamics in Relation to Frailty in Older Adults

机译：与衰弱相关的认知动力学的多状态模型

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Purpose: To analyze cognitive changes in relation to frailty, using a multistate transition model. Methods: In a prospective cohort study of older Canadians (n = 9266), cognitive states were defined as the errors in the Modified Mini-Mental State Examination score. Frailty states were defined using a Frailty Index based on 40 self-reported deficits. Five-year transition probabilities were modeled by the use of a truncated Poisson distribution with the Poisson mean dependent on the baseline cognitive state, frailty, and other covariates. Results: In multivariable analyses, age, frailty status, and education level were independently associated with cognitive changes, whereas only age and frailty were related to the risk of death. Frail people less often showed cognitive improvement (13.4%; 95% confidence interval [CI], 11.8-15) or stabilization (8.9%; 95% CI, 7.5-10.3) compared with non-frail people, of whom 23.9% improved (95% CI, 22.8-25) and 17% (95% CI, 16.1-17.9) maintained their cognitive status. Frail people were more likely to die (47.4%; 95% CI, 44.8%-50%) versus 22.3% (95% CI, 20.1%-24.5%) of non-frail older adults. Conclusion: A multistate transition model can be used to estimate simultaneously the chances of cognitive improvement/stability, decline, and death, and to analyze how these outcomes depend on frailty and other covariates.
机译：目的：使用多状态转换模型分析与体弱相关的认知变化。方法：在一项针对加拿大老年人（n = 9266）的前瞻性队列研究中，认知状态被定义为改良型迷你精神状态检查评分中的错误。使用基于40个自我报告的赤字的脆弱指数定义脆弱状态。通过使用截断的泊松分布对五年过渡概率进行建模，泊松均值取决于基线认知状态，虚弱和其他协变量。结果：在多变量分析中，年龄，虚弱状态和受教育程度与认知变化独立相关，而只有年龄和虚弱与死亡风险相关。与非体弱的人相比，体弱的人较少显示出认知改善（13.4％; 95％的置信区间[CI]，11.8-15）或稳定（8.9％; 95％CI，7.5-10.3），而非体弱的人则改善23.9％（ 95％CI（22.8-25）和17％（95％CI，16.1-17.9）保持了认知状态。体弱的人更有可能死（47.4％; 95％CI，44.8％-50％），而非体弱的老年人则有22.3％（95％CI，20.1％-24.5％）。结论：多状态转换模型可用于同时估计认知改善/稳定性，下降和死亡的机会，并分析这些结果如何取决于脆弱和其他协变量。

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