Abstract：
BACKGROUND: We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores.
METHODS: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1.
RESULTS: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2.
CONCLUSIONS: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out.
METHODS: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1.
RESULTS: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2.
CONCLUSIONS: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out.
摘要：
背景：我们检查了之前的迷你精神状态检查（MMSE）分数波动之间的关系，MMSE分数的未来变化，和后续调查的减员，这有助于更全面地解释反复收集的MMSE评分。
方法：这项为期4年的纵向研究包括日本2,073名年龄≥65岁的社区居住老年人。MMSE在基线(T0)时给予，2年（T1），和4年（T2）随访。我们用因变量进行了多项逻辑回归分析，指示MMSE分数从T1到T2的变化(分类为增加，没有变化[参考类别]，并减少)和T2时的损耗。独立变量包括从T0到T1的MMSE得分的变化以及T0和T1的MMSE得分。
结果：三个时间点的平均MMSE评分为29分。从T0到T1的MMSE得分降低1分与从T1到T2的MMSE得分增加的几率高79%(95%CI:1.62,1.97)和在T2的减员几率高28%(1.17,1.40)相关。在T0和T1时MMSE得分降低1分也与从T1到T2的MMSE得分增加和T2时的减员相关。
结论：关注认知波动2年，而不是某个时间点的认知功能，在关注未来的认知功能和减员时，没有显著的优势。我们的研究结果强调需要进一步研究，以确定那些继续参加后续调查并显示认知测试成绩改善的人和那些辍学的人之间的区别因素。
方法：这项为期4年的纵向研究包括日本2,073名年龄≥65岁的社区居住老年人。MMSE在基线(T0)时给予，2年（T1），和4年（T2）随访。我们用因变量进行了多项逻辑回归分析，指示MMSE分数从T1到T2的变化(分类为增加，没有变化[参考类别]，并减少)和T2时的损耗。独立变量包括从T0到T1的MMSE得分的变化以及T0和T1的MMSE得分。
结果：三个时间点的平均MMSE评分为29分。从T0到T1的MMSE得分降低1分与从T1到T2的MMSE得分增加的几率高79%(95%CI:1.62,1.97)和在T2的减员几率高28%(1.17,1.40)相关。在T0和T1时MMSE得分降低1分也与从T1到T2的MMSE得分增加和T2时的减员相关。
结论：关注认知波动2年，而不是某个时间点的认知功能，在关注未来的认知功能和减员时，没有显著的优势。我们的研究结果强调需要进一步研究，以确定那些继续参加后续调查并显示认知测试成绩改善的人和那些辍学的人之间的区别因素。
