中文摘要：

【提要】目的将阿尔茨海默病（Alzheimer’s disease，AD）进程中的疾病状态和生命质量相结合，探讨阿尔茨海默病健康相关生命质量随疾病状态转移的动态变化规律。方法针对3次随访的纵向资料，以认知正常老化为状态1、轻度认知损害为状态2、中重度认知损害为状态3、阿尔茨海默病为状态4，采用潜变量增长曲线模型，研究AD进程中健康相关生命质量随状态转移的动态变化规律。结果总的来说，初始状态平均生命质量为29．9，处于一般水平，并且存在显著的个体差异；在随访期内，生命质量有先升后降的趋势，但变化速度却不存在显著的个体间差异，而且初始时生命质量的高低与后来的变化速度之间相关不显著。各个状态转移组初始状态生命质量存在着显著的差异，状态2-状态3和状态3-状态4这两个转移组生命质量有明显的先升后降趋势，而且前者升高要较后者明显，生命质量的发展速度存在显著的个体问差异。状态1-状态2和状态3-状态2这两个转移组均未达到显著水平。结论应根据AD进程中不同认知转归结局各自的发展变化，开展疾病分阶段重点防治。潜变量增长模型在纵向研究中考虑到数据个体间差异，在应用中显示出其特有的优势。

英文摘要：

Objective To explore the dynamic changes of health-related quality of life （HRQOL）with state transitions in the Alzheimer＇s disease（AD）process by making quality of life combined with disease status. Methods Based on collected three waves longitudinal data, latent growth curve model （LGCM）was used to focus on the dynamic changes of HRQOL with the state transitions in the AD process. Cognitive normally aging, MCI, moderate or severe cognitive impairment and AD were de- fined as state 1,2,3 and 4, respectively. Results LGCM analysis showed that the average QOL was 29. 9 at baseline, a general level, and there were significant differences between individuals. During follow-up periods, there were inverted-V shapes about QOL, but change speeds did not have significant differences between individuals. Besides, the initial level of QOL was not signif- icantly correlated with the following change speed. In each transition group, the initial states of QOL had significant differences. Groups of state 2 →state 3 and state 3 →state 4 had significant inverted-V trend about QOL. Compared with the latter, the for- mer had higher increased pace and had significant differences between individuals. However, groups of state 1 →state 2 and state 3 →state 2 did not reach significant levels. Conclusion Control and prevention measures in stages during AD progression could be taken based on developments of different cognitive outcomes. For longitudinal data analysis, LGCM demonstrates its u- nique advantages in the practical applications as the differences between individuals can be taken into account.