中国老年人轻度认知功能障碍风险评估的Rothman-Keller模型构建及应用  被引量:5

Construction and application of Rothman-Keller model for risk assessment of mild cognitive impairment in the elderly in China

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作  者:滕菲 井淇 王素珍[1] 王培承[1] 安洪庆[1] TENG Fei;JING Qi;WANG Su-zhen;WANG Pei-cheng;AN Hong-qing(School of Public Health,Weifang Medical College,Weifang,Shandong 261053,China)

机构地区:[1]潍坊医学院公共卫生学院,山东潍坊261053

出  处:《现代预防医学》2023年第11期1932-1938,共7页Modern Preventive Medicine

基  金:国家自然科学基金青年科学基金项目(72004165);中国学位与研究生教育学会研究课题(2020MSA105);山东省高等医学教育研究中心科研规划课题(YJKT202126)。

摘  要:目的探讨老年轻度认知功能障碍的危险因素,构建老年轻度认知功能障碍发病风险预测模型,并应用于老年人群进行实证风险评估。方法通过meta分析获得MCI风险指标及其合并危险值,运用Rothman-Keller法结合风险指标建立MCI发病风险预测模型,采用CLHLS数据作为建模集进行内部验证,CHARLS数据集作为验证集进行外部验证。对模型的区分度、校准度、临床实用性进行评价。结果进入Rothman-Keller模型的因素包括性别、年龄、居住情况、婚姻状况、受教育年限、吸烟、饮酒、锻炼、睡眠、高血压、糖尿病、心脏病、脑卒中、高脂血症。最终得到Rothman-Keller模型的建模集与验证集ROC曲线下面积分别为0.743(95%CI:0.723~0.763,P<0.05)、0.741(95%CI:0.715~0.767,P<0.05),模型具有较好的预测能力;校正曲线均显示模型具有较好的校确度;决策曲线显示模型在4%~92%、3%~90%风险范围内,具有良好的临床实用性。结论Rothman-Keller模型在中国老年人MCI早期风险识别中具有较好的预测能力,有助于辨别老年高危个体并对其进行监测,进而阻止或延缓轻度认知功能障碍进展为痴呆,有助于降低轻度认知功能障碍的发生风险。Objective To explore the risk factors of mild cognitive impairment(MCI)in the elderly,construct a risk prediction model of MCI in the elderly,and apply it to the empirical risk assessment of the elderly.Methods MCI risk index and its combined risk value were obtained by Meta-analysis.Rothman-Keller method combined with risk index was used to establish the risk prediction model of MCI.CLHLS data was used as the modeling set for internal verification,and CHARLS data set was used as the validation set for external verification.The differentiation,calibration,and clinical practicability of the model were evaluated.Results The factors that entered the Rothman-Keller model included sex,age,living condition,marital status,years of education,smoking,drinking,exercise,sleep,hypertension,diabetes,heart disease,stroke,and hyperlipidemia.Finally,the area under the ROC curve of the modeling set and verification set of the Rothman-Keller model was 0.743(95%CI:0.723-0.763,P<0.05)and 0.741(95%CI:0.715-0.767,P<0.05),respectively,indicating good prediction ability.The calibration curves showed that the model had good calibration accuracy.The decision curve showed that the model had good clinical practicability in the risk range of 4%-92%and 3%-90%.Conclusion Rothman-Keller model has good predictive ability in early risk identification of MCI in Chinese elderly.The model is helpful to identify and monitor high-risk individuals in the elderly,so as to prevent or delay the progression of MCI to dementia and reduce the risk of MCI.

关 键 词:Rothman-Keller模型 轻度认知功能障碍 风险预测 Meta分析 

分 类 号:R749.1[医药卫生—神经病学与精神病学]

 

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