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Characteristics of transitions between cardiovascular disease and cognitive frailty states in middle-aged and elderly population based on a multi-state Markov model
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Chengyu CHEN1, 2, 3, Xiyan LI1, 2, 3, Xiao ZHENG3, 4, Xinru LI2, 3, Lingli YANG1, 2, 3, Ting ZHENG2, 3, Yuyang LI2, 3, Chichen ZHANG2, 3
Chinese Nursing Research | 2026, 40(10) : 1658 - 1664
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Chinese Nursing Research | 2026, 40(10): 1658-1664
• Original Articles •
Characteristics of transitions between cardiovascular disease and cognitive frailty states in middle-aged and elderly population based on a multi-state Markov model
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Chengyu CHEN1, 2, 3, Xiyan LI1, 2, 3, Xiao ZHENG3, 4, Xinru LI2, 3, Lingli YANG1, 2, 3, Ting ZHENG2, 3, Yuyang LI2, 3, Chichen ZHANG2, 3
Affiliations
  • 1School of Nursing, Southern Medical University, Guangdong 510515 China
  • 2School of Health Management, Southern Medical University
  • 3Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service
  • 4School of Public Health and Management, Guangzhou University of Chinese Medicine
Published: 2026-05-25 doi: 10.12102/j.issn.1009-6493.2026.10.006
Outline
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Objective

To investigate the relationship between different types of cardiovascular disease and transitions in cognitive frailty states.

Methods

Data from the 2010—2014 Health and Retirement Study (HRS) in the United States and the 2011-2015 China Health and Retirement Longitudinal Study(CHARLS) were selected as data sources. A multi-state Markov model was employed to examine the impact of cardiovascular disease on cognitive frailty transitions.

Results

Among patients with cardiovascular disease,the incidence rates of cognitive frailty,frailty,and cognitive impairment were 2.5%,8.6%,and 16.2%,respectively.A total of 5 990 state transitions were observed,of which deteriorations accounted for 60.2% and improvements accounted for 39.8%.Patients with multimorbid cardiovascular disease were more likely to transition from a normal state to physical frailty and were less likely to recover from deteriorated states compared to those with a single condition.Hypertensive patients demonstrated a higher likelihood of recovery from deteriorated states.

Conclusions

The relationships between different types of cardiovascular disease and transitions in cognitive frailty states vary.Healthcare providers should pay attention to state transitions in patients with different cardiovascular conditions and provide timely,personalized interventions and care.

cardiovascular disease  /  cognitive frailty  /  cognitive impairment  /  multi-state Markov model  /  health management
陈程雨, 李蹊言, 郑晓, 李欣茹, 杨玲莉, 郑婷, 黎羽扬, 张持晨. 基于多状态马尔可夫模型的中老年心血管疾病与认知衰弱状态转变特征研究. 护理研究, 2026 , 40 (10) : 1658 -1664 . DOI: 10.12102/j.issn.1009-6493.2026.10.006
Chengyu CHEN, Xiyan LI, Xiao ZHENG, Xinru LI, Lingli YANG, Ting ZHENG, Yuyang LI, Chichen ZHANG. Characteristics of transitions between cardiovascular disease and cognitive frailty states in middle-aged and elderly population based on a multi-state Markov model[J]. Chinese Nursing Research, 2026 , 40 (10) : 1658 -1664 . DOI: 10.12102/j.issn.1009-6493.2026.10.006
Appendix
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Year 2026 volume 40 Issue 10
34
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Article Info
doi: 10.12102/j.issn.1009-6493.2026.10.006
  • Receive Date：2025-09-29
  • Online Date：2026-10-30
  • Published：2026-05-25
Article Data
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History
  • Received：2025-09-29
  • Revised：2026-04-20
Affiliations
    1School of Nursing, Southern Medical University, Guangdong 510515 China
    2School of Health Management, Southern Medical University
    3Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service
    4School of Public Health and Management, Guangzhou University of Chinese Medicine
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https://castjournals.cast.org.cn/joweb/hlyj/EN/10.12102/j.issn.1009-6493.2026.10.006
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红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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