Document Detail

Changes in cognition during the course of eight years in elderly Japanese Americans: a multistate transition model.
MedLine Citation:
PMID:  20470976     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To analyze cognitive changes in relation to mortality with the use of a multistate transition model. METHODS: In a prospective cohort study of Japanese Americans living in King County, WA, study (n = 1985) cognitive states were defined as the errors in the Cognitive Abilities Screening Instrument score. Transition probabilities were modeled by the use of a modified Poisson distribution with the Poisson mean and mortality dependent on the cognitive state and covariates. RESULTS: During an 8-year follow-up, 21.5% died (95% confidence interval [95% CI], 19.3-23.7), 26.6% experienced cognitive decline (95% CI, 24.2-29.1), and 51.9% remained stable or improved cognitively (95% CI, 49.2-54.6). In multivariable analyses, improvements were notably more likely to occur among younger, more-educated people and in women. Older age, male sex, and less education were each significantly related to mortality. CONCLUSIONS: A multistate transition model can be used to estimate the impact of covariates on the individual probabilities of cognitive improvement, stability, decline, and death. This approach can have advantages for considering how interventions might work on patterns of cognitive change over time, especially if factors associated with the prevention of decline are also associated with risk of death.
Arnold Mitnitski; Nader Fallah; Yougui Wu; Kenneth Rockwood; Amy R Borenstein
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of epidemiology     Volume:  20     ISSN:  1873-2585     ISO Abbreviation:  Ann Epidemiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100013     Medline TA:  Ann Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-6     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Department of Medicine, Dalhousie University, Halifax, NS, Canada.
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MeSH Terms
Asian Americans / statistics & numerical data*
Cognition Disorders / diagnosis*,  epidemiology
Likelihood Functions
Models, Psychological
Multivariate Analysis
Poisson Distribution
Prospective Studies
Psychological Tests
Risk Factors
Statistics, Nonparametric
Time Factors
United States / epidemiology
Grant Support
MOP-64169//Canadian Institutes of Health Research; R01 AG09769/AG/NIA NIH HHS

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