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Joint modelling of longitudinal 3MS scores and the risk of mortality among cognitively impaired individuals


Guure, Chris Bambey and Ibrahim, Noor Akma and Adam, Mohd Bakri and Md Said, Salmiah (2017) Joint modelling of longitudinal 3MS scores and the risk of mortality among cognitively impaired individuals. PLOS ONE, 12 (8). pp. 1-18. ISSN 1932-6203


Background: Modified Mini-Mental State Examination (3MS) is an instrument administered by trained personnel to examine levels of participants’ cognitive function. However, the association between changes in scores over time and the risk of death (mortality) is not known. The aims of this study are to examine the association between 3MS scores and mortality via cognitive impairment among older women and to determine individuals’ risk of changes in scores to better predict their survival and mortality rates. Methods: We propose a Bayesian joint modelling approach to determine mortality due to cognitive impairment via repeated measures of 3MS scores trajectories over a 21-year follow-up period. Data for this study are taken from the Osteoporotic Fracture longitudinal study among women aged 65+ which started in 1986–88. Results: The standard relative risk model from the analyses with a baseline 3MS score after adjusting for all the significant covariates demonstrates that, every unit decrease in a 3MS score corresponds to a non-significant 1.059 increase risk of mortality with a 95% CI of (0.981, 1.143), while the extended model results in a significant 0.09% increased risk in mortality. The joint modelling approach found a strong association between the 3MS scores and the risk of mortality, such that, every unit decrease in 3MS scores results in a 1.135 (13%) increased risk of death via cognitive impairment with a 95% CI of (1.056, 1.215). Conclusion: It has been demonstrated that a decrease in 3MS results has a significant increase risk of mortality due to cognitive impairment via joint modelling, but insignificant when considered under the standard relative risk approach.

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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
Faculty of Science
Institute for Mathematical Research
DOI Number: https://doi.org/10.1371/journal.pone.0182873
Publisher: Public Library of Science
Keywords: Modified Mini-Mental State Examination;Joint modelling; Scores; Instrument administered
Depositing User: Nurul Ainie Mokhtar
Date Deposited: 23 May 2019 01:27
Last Modified: 23 May 2019 01:27
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1371/journal.pone.0182873
URI: http://psasir.upm.edu.my/id/eprint/62244
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