Abstract

Diverse analysis approaches have been proposed to distinguish data missing due to death from nonresponse, and to summarize trajectories of longitudinal data truncated by death. We demonstrate how these analysis approaches arise from factorizations of the distribution of longitudinal data and survival information. Models are illustrated using hypothetical data examples (cognitive functioning in older adults, and quality of life under hospice care) and up to 10 annual assessments of longitudinal cognitive functioning data for 3814 participants in an observational study. For unconditional models, deaths do not occur, deaths are independent of the longitudinal response, or the unconditional longitudinal response averages over the survival distribution. Unconditional models, such as random effects models, may implicitly impute data beyond the time of death. Fully conditional models stratify the longitudinal response trajectory by time of death. Fully conditional models are effective for describing individual trajectories, in terms of either aging (age, or years from baseline) or dying (years from death). Partly conditional models summarize the longitudinal response in the dynamic cohort of survivors. Partly conditional models are serial cross-sectional snapshots of the response. They reflect the average response in survivors at a given timepoint, rather than individual trajectories. Joint models of survival and longitudinal response describe the evolving health status of the entire cohort. Researchers using longitudinal data should consider which method of accommodating deaths is consistent with research aims, and use analysis methods accordingly.

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Biostatistics

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