Estimating Bidirectional Transitions and Identifying Predictors of Mild Cognitive Impairment
Yao Qin, Hongjuan Han, Yang Li, Jing Cui, Haixia Jia, Xiaoyan Ge, Yifei Ma, Wenlin Bai, Rong Zhang, Durong Chen, Fuliang Yi, Hongmei Yu
Abstract
BACKGROUND AND OBJECTIVES: , cognition, daily activity ability, depression, and neuropsychiatric symptoms on transition probabilities. METHODS: We constructed a retrospective cohort by reviewing patients with an MCI diagnosis at study entry and at least 2 follow-up visits between June 2005 and February 2021. Defining NC or near-NC and MCI as transient states and dementia as an absorbing state, we used continuous-time multistate Markov models to estimate instantaneous transition intensity between states, transition probabilities from one state to another at any given time during follow-up, and hazard ratios of reversion-related variables. RESULTS: , cognition, daily activity ability, depression, and neuropsychiatric symptoms were significant predictors of bidirectional transitions. DISCUSSION: The nature of bidirectional transitions cannot be ignored in multidimensional MCI research. We found that postreversion participants remained at an increased risk of progression to MCI or dementia over the longer term and experienced recurrent reversions. Our findings may serve as a valuable reference for future research and enable health care professionals to better develop proactive management plans and targeted interventions.