Illness and dependency: description of changes using multistate models

Citation
F. Gauzere et al., Illness and dependency: description of changes using multistate models, POPULATION, 54(2), 1999, pp. 205-222
Citations number
23
Categorie Soggetti
Sociology & Antropology
Journal title
POPULATION
ISSN journal
00324663 → ACNP
Volume
54
Issue
2
Year of publication
1999
Pages
205 - 222
Database
ISI
SICI code
0032-4663(199903/04)54:2<205:IADDOC>2.0.ZU;2-S
Abstract
The progression of an illness can be modelled with a three-state model: hea lthy, ill, dead. The model used in this article contains no reversible tran sitions: it is fully specified hv the transition intensities between the di fferent states. Such an approach is of value in epidemiology, because the t ransition intensities to the dead state represent the instantaneous death r ates for the ill and healthy, while the transition intensity from the healt hy state to the sick state corresponds to the instantaneous incidence of th e illness, Smoothed estimates are given for the different transition intens ities between the different states; the probability of occupying a given st ate at a given age can be inferred from the intensities, and the prevalence of the illness is calculated by the ratio between the probability of being ill and the probability of being alive. This method is applied here to dat a from the PAQUID study to describe the evolution of serious dependency amo ng elderly people over 65 living in southwest France. The prevalence of ser ious dependency increases with age for both sexes. The agr-related increase in the intensities of the transition to dependency is faster for women tha n for men.