Keywords: multi-state models, dementia, mild cognitive impairment, subjective complaints
This paper will present an overview on the use of multi-state models in identifying and studying early signs of a cognitive decline among the elderly. Some early signs include the declaration of a subjective memory complaint often observed in the elderly and transitions into a mild cognitive impairment. Since neither sign guarantees a future transition into a demented state, multi-state models are useful tools for making adjustments for the competing risk of death without a dementia, for studying long sojourn times in intermediate states, and for modeling back transitions into more normal cognitive states. Data from the Statistical Modeling of Aging and Risk Transitions project, a consortium of 11 longitudinal studies of aging will be used to illustrate the results.