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Disability risk prediction model based on machine learning among Chinese healthy older adults

Results from the China Health and Retirement Longitudinal Study

Bibliographic Data

ID22067696
AuthorsYuchen Han (0000-0003-1308-4197, Hubei University of Medicine), Shaobing Wang (0000-0002-9580-804X, Hubei University of Medicine, corresponding author)
Year2023
Volume11
Pages1271595-1271595
Publication date2023-11-09
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2023.1271595
PMID38026309
OpenAlexW4388616532
LanguageEN
Citations received7
References cited70

Background: Predicting disability risk in healthy older adults in China is essential for timely preventive interventions, improving their quality of life, and providing scientific evidence for disability prevention. Therefore, developing a machine learning model capable of evaluating disability risk based on longitudinal research data is crucial. Methods: We conducted a prospective cohort study of 2,175 older adults enrolled in the China Health and Retirement Longitudinal Study (CHARLS) between 2015 and 2018 to develop and validate this prediction model. Several machine learning algorithms (logistic regression, k-nearest neighbors, naive Bayes, multilayer perceptron, random forest, and XGBoost) were used to assess the 3-year risk of developing disability. The optimal cutoff points and adjustment parameters are explored in the training set, the prediction accuracy of the models is compared in the testing set, and the best-performing models are further interpreted. Results: During a 3-year follow-up period, a total of 505 (23.22%) healthy older adult individuals developed disabilities. Among the 43 features examined, the LASSO regression identified 11 features as significant for model establishment. When comparing six different machine learning models on the testing set, the XGBoost model demonstrated the best performance across various evaluation metrics, including the highest area under the ROC curve (0.803), accuracy (0.757), sensitivity (0.790), and F1 score (0.789), while its specificity was 0.712. The decision curve analysis (DCA) indicated showed that XGBoost had the highest net benefit in most of the threshold ranges. Based on the importance of features determined by SHAP (model interpretation method), the top five important features were identified as right-hand grip strength, depressive symptoms, marital status, respiratory function, and age. Moreover, the SHAP summary plot was used to illustrate the positive or negative effects attributed to the features influenced by XGBoost. The SHAP dependence plot explained how individual features affected the output of the predictive model. Conclusion: Machine learning-based prediction models can accurately evaluate the likelihood of disability in healthy older adults over a period of 3 years. A combination of XGBoost and SHAP can provide clear explanations for personalized risk prediction and offer a more intuitive understanding of the effect of key features in the model

Artificial neural network · Logistic regression · Longitudinal study · Machine learning · Multilayer perceptron · Naive Bayes classifier · Psychological intervention · Random forest · Receiver operating characteristic · Support vector machine · Artificial Intelligence in Healthcare · Chronic Disease Management Strategies · Computer Science · Machine Learning in Healthcare · Medicine · Artificial Intelligence · Gerontology

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Citations per year3.5
Citation span2024 - 2026 (3)
Highly citedNo

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