Dynamic predictions in Bayesian functional joint models for longitudinal and time-to-event data: An application to Alzheimer's disease

In the study of Alzheimer's disease, researchers often collect repeated measurements of clinical variables, event history, and functional data. If the health measurements deteriorate rapidly, patients may reach a level of cognitive impairment and are diagnosed as having dementia. An accurate prediction of the time to dementia based on the information collected is helpful for physicians to monitor patients' disease progression and to make early informed medical decisions. In this article, we first propose a functional joint model to account for functional predictors in both longitudinal and survival submodels in the joint modeling framework. We then develop a Bayesian approach for parameter estimation and a dynamic prediction framework for predicting the subjects' future outcome trajectories and risk of dementia, based on their scalar and functional measurements. The proposed Bayesian functional joint model provides a flexible framework to incorporate many features both in joint modeling of longitudinal and survival data and in functional data analysis. Our proposed model is evaluated by a simulation study and is applied to the motivating Alzheimer's Disease Neuroimaging Initiative study.