Objective The aim of this study was to explore the natural history of Alzheimer's disease(AD)based on the multi-state Markov model and to provide methodological reference for the chronic diseases.Methods Based on the American public database ADNI,we constructed a three states Markov model to estimate the transition intensity,transition probability,influencing factors and sojourn time of different states.Survival curves and goodness of fit was obtained.Results Gender,age,FAQ,MMSE,CDRSB,ADAS13 and TMT-B-Time were important influencing factors in the natural history of AD.The mean sojourn time of NC and MCI was 7.502 and 11.621 years,respectively.Model fit can be accepted.Conclusion Multi-state Markov model has a good application value for the outcome prediction of multi-state chronic diseases such as AD.
Multi-state Markov modelAlzheimer's diseaseChronic diseaseNatural history