基于风险预测模型的老年人营养脆弱现象型的开发和验证:基于人口的前性队列研究的结果
Hongpeng Liu1, Qinqin Liu1, Huaxin Si1
1School of Nursing, Peking University, Beijing, China.
Journal of the American Medical Directors Association
|December 22, 2024
概括
使用机器学习开发了一种新的营养脆弱现型,用于预测老年人的不良结果. 这个模型强调了弱点和缓慢的重要性,表明营养和运动干预可以预防脆弱.
科学领域:
- 老年学是一门学科.
- 营养科学 营养科学
- 医疗保健中的机器学习
背景情况:
- 营养不良与老年人的脆弱轨迹和不良结果有关.
- 脆弱是多维的,需要对营养成分进行评估.
- 现有的脆弱工具可能无法完全捕捉营养对健康结果的影响.
研究的目的:
- 评估营养因素在脆弱工具中对不利结果的贡献.
- 开发和验证基于机器学习的营养脆弱现象型.
- 确定老年人不良结果的关键预测因素.
主要方法:
- 基于人口的前性队列研究,使用中国健康与退休纵向研究 (CHARLS).
- 最小绝对收缩和选择运算子 (LASSO) 回归用于预测器选择.
- 机器学习模型 (随机森林,极端梯度提升) 和修改的Poisson回归用于表型开发和验证.
主要成果:
- 缓慢 (步行速度),下肢功能 (椅子站) 和上肢功能 (握力) 是关键预测因素.
- 模型证明了可接受的歧视所有原因死亡率和训练集中的综合结果.
- 外部验证显示所有模型的歧视和预测性能都可接受,并且对事故残疾预测进行了良好的校准.
结论:
- 一种新的营养脆弱性表型显示出降低老年人不良结果的潜力.
- 软弱和缓慢是营养脆弱性进展的关键因素.
- 营养补充剂和运动干预措施的结合可以预防或延迟不良结果.
相关概念视频
Bioavailability Study Design: Healthy Subjects Versus Patients
Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
Development of Human Microbiota
The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from the skin...


