老年人步速减慢的风险预测模型  

Prediction model for the risk of pace slow in the elderly

作　　者：桂青 吴亦影[1] 安丽娜 董晓慧 吴方[2] 李菲卡[2] 马丽娜[3] 王青[4] 吴锦晖[5] 倪秀石[1] Gui Qing;Wu Yiying;An Lina;Dong Xiaohui;Wu Fang;Li Feika;Ma Lina;Wang Qing;Wu Jinhui;Ni Xiushi(Department of Geriatrics,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,200080,P.R.China;Department of Geriatrics,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200025,P.R.China;Department of Geriatrics,Xuanwu Hospital Capital Medical University,National Clinical Research Center for Geriatric Diseases,Beijing,100053,P.R.China;Department of Geriatrics,Fuxing Hospital Affiliated to Capital Medical University,Beijing,100038,P.R.China;Department of Geriatrics,West China Hospital,Sichuan University,National Clinical Research Center for Geriatric Disease,Chengdu,Sichuan,610041,P.R.China)

机构地区：[1]上海交通大学附属第一人民医院老年医学科,上海200080 [2]上海交通大学医学院附属瑞金医院老年医学科,上海200025 [3]首都医科大学宣武医院老年医学科,国家老年疾病临床医学研究中心,北京100053 [4]首都医科大学附属复兴医院老年医学科,北京100038 [5]四川大学华西医院老年医学科,国家老年疾病临床医学研究中心,四川成都610041

出　　处：《老年医学与保健》2022年第2期410-414,共5页Geriatrics & Health Care

基　　金：国家重点研发计划(2018YFC2002101,2018YFC2002100)。

摘　　要：目的分析老年人步速减慢的危险因素,建立步速减慢的简易风险预测模型。方法以≥60岁的老年人为研究对象,采用横断面研究方法,收集受试者的一般资料、生活习惯、患病史以及实验室指标等。通过单因素分析和多因素分析,确定步速减慢的独立危险因素。基于独立危险因素建立模型,最后对该模型的预测效能进行验证。结果共纳入546例受试者,其中278例受试者存在步速减慢。认知障碍、年龄增大、体力活动减少、代谢综合征、焦虑症、低血清白蛋白及高密度脂蛋白胆固醇降低是老年人发生步速减慢的独立危险因素。根据危险因素构建风险预测模型,并绘制列线图。该模型的应用受试者操作特征曲线下面积为0.828(P<0.001,95%CI:0.794~0.862),显示出良好的区分性。应用校准曲线校准该模型,模型的预测曲线与理想曲线基本重合,表现出较强的校准能力,模型决策曲线远离两条极端的直线。最后采用B ootstrap自抽样法对该模型进行内部校验。结论该模型对高危个体发生步速减慢的预测效果好,可为老年人步速减慢的风险预测提供一定的参考。Objective To analyze the risk factors of pace slow in the elderly,and to establish a simple risk prediction model for pace slow.Methods Taking the elderly≥60 years old as the research subjects,a cross-sectional research method was used to collect the general data,living habits,disease history and laboratory indexes of the subjects.Univariate analysis and multivariate analysis were used to determine the independent risk factors of pace slow.A predictive model was established based on the independent risk factors,and then the predictive performance of the model was verified.Results A total of 546 subjects were included in this study,of which 278 ones suffered from pace slow.Cognitive impairment,increased age,decreased physical activity,metabolic syndrome,anxiety,low level of serum albumin and high-density lipoprotein cholesterol were independent risk factors for pace slow in the elderly.According to the risk factors,a risk predictive model was established and nomogram was drawn.The area under the receiver operating characteristic curve of the model was 0.828(P<0.001,95%CI:0.794-0.862),showing good discrimination.The calibration curve was used to calibrate the model and the prediction curve of the model basically coincided with the ideal curve,showing strong calibration ability.Finally,Bootstrap self-sampling method was used to verify the model.Conclusion This model has a good prediction effect on the occurrence of pace slow in high-risk individuals,which can provide a certain reference for the risk prediction of pace slow in the elderly.

关 键 词：老年 步速减慢 风险预测模型 列线图 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]