title: Reversible States of Physical and/or Cognitive Dysfunction: A 9-Year Longitudinal Study.
abstract: To determine 1) age-adjusted transition probabilities to worsening physical/cognitive function states, reversal to normal cognition/physical function, or maintenance of normal state; 2) whether these transitions are modulated by sex, BMI, education, hypertension (HTN), health status, or APOE4; 3) whether worsening gait speed preceded cognition change, or vice versa.
  
  
  
  Analysis of 9-year prospective cohort data from the New Mexico Aging Process Study.
  
  
  
  Healthy independent-living adults.
  
  
  
  60+ years of age (n= 598).
  
  
  
  Gait speed, cognitive function (3MSE score), APOE4, HTN, BMI, education, health status.
  
  
  
  Over 9 years, 2129 one-year transitions were observed. 32.6% stayed in the same state, while gait speed and cognitive function (3MSE scores) improved for 38% and 43% of participants per year, respectively. Transitions to improved function decreased with age (P< 0.001), APOE4 status (P=0.02), BMI (P=0.009), and health status (P=0.009). Transitions to worse function were significantly increased for the same factors (all P<0.05). Times to lower gait speed and cognitive function did not precede each other (P=0.91).
  
  
  
  Transitions in gait speed and cognition were mutable with substantial likelihood of transition to improvement in physical and cognitive function even in oldest-old, which may have clinical implications for treatment interventions.
authors.affiliation: Prof Clifford Qualls, Department of Mathematics and Statistics and School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA, cqualls@salud.unm.edu.
authors.forename: C
authors.initials: C
authors.lastname: Qualls
authors.forename: D L
authors.initials: DL
authors.lastname: Waters
authors.forename: B
authors.initials: B
authors.lastname: Vellas
authors.forename: D T
authors.initials: DT
authors.lastname: Villareal
authors.forename: P J
authors.initials: PJ
authors.lastname: Garry
authors.forename: A
authors.initials: A
authors.lastname: Gallini
authors.forename: S
authors.initials: S
authors.lastname: Andrieu
mesh_terms: D000368:Aged; D053327:Apolipoprotein E4 / Q000097:blood; D015415:Biomarkers; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000523:psychology* / Q000628:therapy; D004522:Educational Status; D005260:Female; D005684:Gait / Q000502:physiology*; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009516:New Mexico; D011446:Prospective Studies; D016138:Walking / Q000502:physiology*
chemical_list: D053327:Apolipoprotein E4; D015415:Biomarkers
keywords: Cognitive function; gait speed; multi-state modelling; reversible transitions