chronic diseases

慢性疾病
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:这项横断面研究使用2013-2018年国家健康和营养检查调查(NHANES)数据,检查了美国成年人的慢性病与自杀念头之间的联系,旨在确定自杀意念的潜在危险因素。
    方法:使用NHANES数据,我们分析了各种慢性疾病(高血压,糖尿病,哮喘,等。)和自杀念头,采用针对人口统计和生活方式因素进行调整的逻辑回归模型。
    结果:对8891名参与者的分析显示,自杀念头与慢性疾病如肝病之间存在显著关联,糖尿病,和哮喘。随着慢性病的数量增加,自杀意念的风险更高。
    结论:我们的研究结果表明,慢性疾病的存在和数量与自杀念头的风险之间存在很强的联系,强调解决身心健康需求的综合护理方法的重要性。
    BACKGROUND: This cross-sectional study examines the link between chronic diseases and suicidal thoughts in U.S. adults using 2013-2018 National Health and Nutrition Examination Survey (NHANES) data, aiming to identify potential risk factors for suicidal ideation.
    METHODS: Using NHANES data, we analyzed the association between various chronic conditions (hypertension, diabetes, asthma, etc.) and suicidal thoughts, employing logistic regression models adjusted for demographics and lifestyle factors.
    RESULTS: The analysis of 8891 participants revealed a significant association between suicidal thoughts and chronic diseases such as liver disease, diabetes, and asthma. The risk of suicidal ideation is higher with the number of chronic conditions.
    CONCLUSIONS: Our findings suggest a strong link between the presence and number of chronic diseases and the risk of suicidal thoughts, emphasizing the importance of integrated care approaches that address both physical and mental health needs.
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  • 文章类型: Journal Article
    高脂饮食(HFD)已被认为是慢性疾病风险的主要因素。肥胖,糖尿病,胃肠道疾病,神经退行性疾病,心血管疾病长期以来被认为是世界范围内发病率高的慢性疾病。在这次审查中,系统总结了肠道菌群及其相应的细菌代谢产物对HFD引起的慢性疾病的作用机制。众所周知,肠道微生物群失衡也会增加对疾病的易感性。一些研究已经证明HFD对肠道微生物群有负面影响,也加剧了许多慢性疾病的过程中,通过增加的种群,兼性厌氧细菌,和机会性病原体。因为胆汁酸,脂多糖,短链脂肪酸,和三甲胺N-氧化物长期以来被认为是细菌代谢产物的共同特征,我们将探讨在HFD诱导的慢性疾病中这些代谢物和肠道微生物群之间的协同机制的可能性。有关HFD介导的肠道微生物群的机制作用的最新文献已从PubMed收集,谷歌学者,还有Scopus.这篇综述的目的是提供对这些机制的新见解,并指出HFD介导的肠道微生物群的潜在生物标志物。
    High-fat diet (HFD) has been recognized as a primary factor in the risk of chronic disease. Obesity, diabetes, gastrointestinal diseases, neurodegenerative diseases, and cardiovascular diseases have long been known as chronic diseases with high worldwide incidence. In this review, the influences of gut microbiota and their corresponding bacterial metabolites on the mechanisms of HFD-induced chronic diseases are systematically summarized. Gut microbiota imbalance is also known to increase susceptibility to diseases. Several studies have proven that HFD has a negative impact on gut microbiota, also exacerbating the course of many chronic diseases through increased populations of Erysipelotrichaceae, facultative anaerobic bacteria, and opportunistic pathogens. Since bile acids, lipopolysaccharide, short-chain fatty acids, and trimethylamine N-oxide have long been known as common features of bacterial metabolites, we will explore the possibility of synergistic mechanisms among those metabolites and gut microbiota in the context of HFD-induced chronic diseases. Recent literature concerning the mechanistic actions of HFD-mediated gut microbiota have been collected from PubMed, Google Scholar, and Scopus. The aim of this review is to provide new insights into those mechanisms and to point out the potential biomarkers of HFD-mediated gut microbiota.
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  • 文章类型: Journal Article
    本研究旨在通过一项随机比较试验,验证M-O-A远程监护干预模式在改善空巢老年慢性病患者健康状况和生活质量方面的有效性。
    M-O-A远程监护干预模型是根据参与者的需求构建的。对照组(N=39)接受常规护理,实验组(N=39)在常规护理的基础上接受M-O-A远程监护干预.经过12周的干预,评估了作为两组参与者的干预效果.采用SPSS26.0进行数据分析。
    经过12周的干预,对于实验组来说,基于EQ-5D-3L的生活质量的每个维度都变得更好,尤其是“疼痛/不适”,“\”焦虑/抑郁,“HRQoL”和“EQ-VAS”(所有p<0.05),基于SF-36的生活质量的每个维度也变得更好,特别是对于“GH”,\“\”BP,\"\"RE,\"\"MH,\"\"VT,\"\"SF,\"\"PCS,\"\"MCS,“SF-36”(所有p<0.05)。此外,血压有统计学的下降趋势,血糖,体重,BMI,脂肪率,午睡持续时间,夜间觉醒的次数,轻度睡眠率和水率的统计上升趋势,基础代谢率,夜间睡眠持续时间,深度睡眠率,快速眼动睡眠率,特别是在干预结束时(所有p<0.05)。而对于对照组,在所有这些方面都没有统计学上的改善。
    M-O-A远程监测模型能有效调节空巢老年慢性病患者的生活质量和健康状况,值得进一步推广应用。
    UNASSIGNED: This study aims to verify the effectiveness of M-O-A telenursing intervention model in improving the health status and quality of life of the empty-nest older adult individuals with chronic diseases by a randomized comparative trial.
    UNASSIGNED: M-O-A telenursing intervention model was constructed based on the needs of the participants. The control group (N = 39) received routine nursing, the experimental group (N = 39) received M-O-A telenursing intervention in addition to routine nursing. After 12 weeks of intervention, the intervention effects of being a participant in the two groups were evaluated. SPSS 26.0 was used for data analysis.
    UNASSIGNED: After 12 weeks of intervention, for the experimental group, each dimension of quality of life based on EQ-5D-3L became better, especially for \"pain/discomfort,\" \"anxiety/depression,\" \"HRQoL\" and \"EQ-VAS\" (all p < 0.05) and each dimension of quality of life based on SF-36 became better too, especially for \"GH,\" \"BP,\" \"RE,\" \"MH,\" \"VT,\" \"SF,\" \"PCS,\" \"MCS,\" \"SF-36\" (all p < 0.05). In addition, there was a statistical downward trend in blood pressure, blood glucose, weight, BMI, fat rate, nap duration, number of nocturnal awakenings, light sleep rate and a statistical upward trend in water rate, basal metabolic rate, nighttime sleep duration, deep sleep rate, rapid eye movement sleep rate, especially at the end of intervention (all p < 0.05). While for the control group, there was no statistical improvement in all these aspects.
    UNASSIGNED: The M-O-A telenursing model could effectively regulate quality of life and health condition of the empty-nest older adult individuals with chronic diseases, making it worthy of further promotion and application.
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  • 文章类型: Journal Article
    生物银行,通过收集和储存病人的血液,组织,基因组,和其他生物样本,为心血管疾病等慢性病的研究和管理提供独特而丰富的资源,糖尿病,和癌症。这些样本包含有价值的细胞和分子水平信息,可用于破译疾病的发病机理,指导新型诊断技术的发展,治疗方法,个性化医疗策略。本文首先概述了生物银行的历史演变,他们的分类,以及技术进步的影响。随后,它阐述了生物库在揭示慢性病的分子生物标志物中的重要作用,促进基础研究向临床应用的转化,实现个体化治疗和管理。此外,样品处理标准化等挑战,信息隐私,并讨论了安全性。最后,从政策支持的角度来看,监管改善,和公众参与,本文对生物银行的未来发展方向和应对挑战的策略进行了预测,旨在维护和增强其在支持慢性病预防和治疗方面的独特优势。
    Biobanks, through the collection and storage of patient blood, tissue, genomic, and other biological samples, provide unique and rich resources for the research and management of chronic diseases such as cardiovascular diseases, diabetes, and cancer. These samples contain valuable cellular and molecular level information that can be utilized to decipher the pathogenesis of diseases, guide the development of novel diagnostic technologies, treatment methods, and personalized medical strategies. This article first outlines the historical evolution of biobanks, their classification, and the impact of technological advancements. Subsequently, it elaborates on the significant role of biobanks in revealing molecular biomarkers of chronic diseases, promoting the translation of basic research to clinical applications, and achieving individualized treatment and management. Additionally, challenges such as standardization of sample processing, information privacy, and security are discussed. Finally, from the perspectives of policy support, regulatory improvement, and public participation, this article provides a forecast on the future development directions of biobanks and strategies to address challenges, aiming to safeguard and enhance their unique advantages in supporting chronic disease prevention and treatment.
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  • 文章类型: Journal Article
    随着中国老年人衰老进程的加快,慢性病正成为对他们身心健康的严重威胁。家庭临终关怀满足了不同的需求,并提高了接近生命终点的老年人的生活质量。为了确保患有慢性病的老年人在生命结束时的福祉,探索和评估家中绝症老年人的多维临终关怀需求至关重要。这项研究的目的是调查中国老年人在生命末期的家庭临终关怀护理需求的现状。并分析影响因素(社会人口统计学和疾病相关因素)。
    在这项横断面研究中,从锦州市4个社区卫生服务中心的社区中筛选出247名高龄成年慢性病患者,辽宁省2023年6月至10月采用随机抽样的方法。采用本课题组编制的一般资料问卷和家庭临终关怀护理需求问卷进行调查。采用独立样本t检验或单因素方差分析比较不同特征得分的差异,并选取差异显著的因素进行多元线性回归分析,确定最终的影响因素。
    垂死的老年人的家庭临终关怀需求总分为115.70±12,每个维度的平均分数降序为信息需求(3.96±0.61),社会支持需求(3.96±0.44),精神需求(3.92±0.43),物理需求(3.60±0.59),心理需求(3.37±0.65)。居住状况,病程(年),疾病的类型,生活自理能力是家庭临终关怀需求总分的影响因素。
    患有绝症的老年人对临终关怀的需求很高,医疗保健专业人员应根据需求的影响因素实施服务,以满足其多维需求并提高其生活质量。
    UNASSIGNED: Chronic diseases are becoming a serious threat to the physical and mental health of older people in China as their aging process picks up speed. Home hospice care addresses diverse needs and enhances the quality of life for older adult individuals nearing the end of life. To ensure the well-being of chronically ill older adults at the end of life, it is vital to explore and assess the multidimensional hospice needs of terminally ill older individuals in their homes. The aim of this study was to investigate the current situation of home hospice care needs of Chinese older adults with chronic diseases at the end of life, and to analyze the influencing factors (sociodemographic and disease-related factors).
    UNASSIGNED: In this cross-sectional study, 247 older adult people with chronic diseases at the end of life were selected from the communities of 4 community health service centers in Jinzhou City, Liaoning Province from June to October 2023 by random sampling method. A general information questionnaire and the home hospice care needs questionnaire developed by our research group were used to investigate. Independent samples t-test or one-way ANOVA was used to compare the differences in the scores of different characteristics, and the factors with significant differences were selected for multivariate linear regression analysis to determine the final influencing factors.
    UNASSIGNED: The total score of home hospice needs of the dying older adult was 115.70 ± 12, with the mean scores for each dimension in descending order being Information Needs (3.96 ± 0.61), Social Support Needs (3.96 ± 0.44), Spiritual Needs (3.92 ± 0.43), Physical Needs (3.60 ± 0.59), Psychological Needs (3.37 ± 0.65). Status of residence, duration of illness (year), the type of disease, and self-care ability were influential factors in the total score of home hospice needs.
    UNASSIGNED: The need for hospice care for the terminally ill older adult is high, and healthcare professionals should implement services according to the influencing factors of need to meet their multidimensional needs and improve their quality of life.
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  • 文章类型: Journal Article
    由于其患病率和异质性的升高,乳腺癌(BC)在欧洲代表了重大的健康挑战。尽管在诊断和治疗方法方面取得了显著进展,该地区继续努力应对不断上升的不列颠哥伦比亚省负担,对此事的全面调查尤其缺乏。这项研究探讨了1990年至2019年44个欧洲国家的BC负担和潜在的危险因素。目的是提供证据支持制定有效管理BC的战略。
    来自东部地区2019年全球疾病负担(GBD2019)的与乳腺癌相关的疾病负担估计中央,和西欧使用Joinpoint回归检查了1990年至2019年的趋势。线性回归模型检验了BC负担与社会人口指数(SDI)之间的关系,医疗保健准入和质量(HAQ),和BC患病率。我们利用残疾调整生命年(DALY)比例来描述每个风险因素的BC风险。
    在欧洲,2019年,不列颠哥伦比亚省的负担为每10万人463.2例,是全球负担的1.7倍。女性的BC负担显着升高,并且随着年龄的增长而增加。2019年欧洲不列颠哥伦比亚省的年龄标准化死亡率和DALY率分别下降了23.1%(年均百分比变化:AAPC-0.92)和25.9%(AAPC-1.02),分别,与1990年相比,符合全球趋势。从1990年到2019年,西欧的年龄标准化DALY下降更快(-34.8%,AAPC-1.49)比东欧(-9.4%,AAPC-0.25)和中欧(-15.0%,AAPC-0.56)。摩纳哥,塞尔维亚,黑山在2019年是欧洲公元前负担最高的国家。BC负荷与HAQ呈负相关。此外,饮酒和吸烟是DALY的重要危险因素。高空腹血糖和肥胖也是DALY不可忽视的重要危险因素。
    不列颠哥伦比亚省在欧洲的负担仍然是一个重大的健康挑战,尽管总体呈下降趋势,但区域差异很大。解决不列颠哥伦比亚省在欧洲不同地区的负担和不同风险因素导致的DALY增加,应采取有针对性的预防措施,特别是加强烟酒管理,应该普及BC的筛查服务,优化医疗资源和技术配置。
    UNASSIGNED: Breast cancer (BC) represents a significant health challenge in Europe due to its elevated prevalence and heterogeneity. Despite notable progress in diagnostic and treatment methods, the region continues to grapple with rising BC burdens, with comprehensive investigations into this matter notably lacking. This study explores BC burden and potential contributing risk factors in 44 European countries from 1990 to 2019. The aim is to furnish evidence supporting the development of strategies for managing BC effectively.
    UNASSIGNED: Disease burden estimates related to breast cancer from the Global Burden of Disease 2019(GBD2019) across Eastern, Central, and Western Europe were examined using Joinpoint regression for trends from 1990 to 2019. Linear regression models examined relationships between BC burden and Socio-demographic Index (SDI), healthcare access and quality (HAQ), and BC prevalence. We utilized disability-adjusted life year(DALY) proportions for each risk factor to depict BC risks.
    UNASSIGNED: In Europe, the BC burden was 463.2 cases per 100,000 people in 2019, 1.7 times the global burden. BC burden in women was significantly higher and increased with age. Age-standardized mortality and DALY rates of BC in Europe in 2019 decreased by 23.1%(average annual percent change: AAPC -0.92) and 25.9%(AAPC -1.02), respectively, compared to 1990, in line with global trends. From 1990 to 2019, age-standardized DALY declined faster in Western Europe (-34.8%, AAPC -1.49) than in Eastern Europe (-9.4%, AAPC -0.25) and Central Europe (-15.0%, AAPC -0.56). Monaco, Serbia, and Montenegro had the highest BC burden in Europe in 2019. BC burden was negatively correlated with HAQ. In addition, Alcohol use and Tobacco were significant risk factors for DALY. High fasting plasma glucose and obesity were also crucial risk factors that cannot be ignored in DALY.
    UNASSIGNED: The burden of BC in Europe remains a significant health challenge, with regional variations despite an overall downward trend. Addressing the burden of BC in different regions of Europe and the increase of DALY caused by different risk factors, targeted prevention measures should be taken, especially the management of alcohol and tobacco should be strengthened, and screening services for BC should be popularized, and medical resources and technology allocation should be optimized.
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  • 文章类型: Journal Article
    目前尚不清楚抑郁症状是否与全因死亡率增加相关,以及抑郁症状在多大程度上与慢性病和全因死亡率相关。本研究旨在探讨抑郁症状与全因死亡率的关系,以及抑郁症状可能有多大,反过来,慢性疾病影响中国中老年人全因死亡率。
    数据来自中国健康与退休纵向研究(CHARLS)。这项队列研究涉及从CHARLS的第1波(2011年)到第6波(2020年)的13,855名个体,这是一项具有全国代表性的调查,收集45岁及以上中国居民的信息,以探索抑郁症状和全因死亡率之间的内在机制。流行病学研究中心抑郁量表(CES-D-10)通过CHARLS进行了验证。协变量包括社会经济变量,生活习惯,和自我报告的慢性病史。Kaplan-Meier曲线通过抑郁症状水平描述了死亡率,Cox比例风险回归模型估计全因死亡率的风险比(HRs)。
    在总共13,855名参与者中,中位(Q1,Q3)年龄为58.00(51.00,63.00)岁.对所有协变量进行了调整,有抑郁症状的中老年人的全因死亡率较高(HR=1.20[95%CI,1.09-1.33]).观察到55-64岁(HR=1.23[95%CI,1.03-1.47])和65岁以上(HR=1.32[95%CI,1.18-1.49])的比率增加,农业户口(HR=1.44,[95%CI,1.30-1.59]),和非农业工作量(HR=1.81[95%CI,1.61-2.03])。抑郁症状增加了高血压患者全因死亡的风险(HR=1.19[95%CI,1.00-1.40]),糖尿病(HR=1.41[95%CI,1.02-1.95]),和关节炎(HR=1.29[95%CI,1.09-1.51])。
    抑郁症状增加全因死亡风险,特别是在55岁及以上的人群中,农村户籍(农业户口),非农业工人,中老年人高血压患者,糖尿病,和关节炎。通过本研究收集的纵向数据,我们的发现为针对抑郁症的干预措施提供了有价值的见解。例如早期检测,综合慢性病护理管理,和健康的生活方式;和社区支持抑郁症状可能有助于降低中老年人的死亡率。
    UNASSIGNED: It remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases.
    UNASSIGNED: Data were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan-Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality.
    UNASSIGNED: Out of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09-1.33]). An increased rate was observed for 55-64 years old (HR = 1.23 [95% CI, 1.03-1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18-1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30-1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61-2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00-1.40]), diabetes (HR = 1.41[95% CI, 1.02-1.95]), and arthritis (HR = 1.29 [95% CI, 1.09-1.51]).
    UNASSIGNED: Depressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.
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  • 文章类型: Journal Article
    背景:有机氯农药,它们的环境持久性和生物蓄积性潜力,获得了极大的关注。本研究探讨了有机氯农药对死亡率和慢性病的影响,调查它们与炎症状态的联系,并研究了抗炎饮食在减轻这些农药不良反应中的作用。
    方法:本研究,有2,847名参与者,使用气相色谱和质谱法测量NHANES数据中的有机氯农药暴露。传统的统计方法,包括生存曲线,Cox比例风险回归,回归分析,和受限二次样条分析,被用来调查杀虫剂和死亡率之间的关系,慢性疾病,和炎症。此外,机器学习技术,包括RF,AdaBoost,额外的树木,LightGBM,和BPNN,被用来评估农药对慢性病和死亡率预测的影响。
    结果:有机氯农药与死亡率的增加呈显著正相关(p<0.05)。此外,这些污染物与慢性肾病等慢性疾病的发病率有关,糖尿病,和高血压(p<0.05)。我们的研究,利用各种机器学习模型,当将有机氯农药指标纳入模型而不是排除它们时,曲线下的面积也显着增加。此外,在这些物质的血清C反应蛋白(CRP)和CRP与血清白蛋白比(CAR)浓度之间观察到强烈的相关性,证明它们在特定浓度下的促炎作用。有趣的是,通过改变饮食来减少饮食炎症,有效地降低了在高有机氯农药暴露水平下的死亡风险,但在低至中等暴露水平下,效果不太明显。
    结论:接触有机氯农药与更高的死亡风险有关,可能是由于慢性疾病的患病率增加。在这种情况下,炎症起了至关重要的作用,采用抗炎饮食显著降低了与这些杀虫剂相关的死亡风险。
    BACKGROUND: Organochlorine pesticides, with their environmental persistence and bioaccumulation potential, have gained significant attention. This study explores the impact of organochlorine pesticides on mortality and chronic diseases, investigates their link to inflammatory states, and examines the role of anti-inflammatory diets in mitigating adverse reactions to these pesticides.
    METHODS: This study, with 2,847 participants, used gas chromatography and mass spectrometry to measure organochlorine pesticide exposure in NHANES data. Conventional statistical methodologies, encompassing survival curves, Cox proportional hazards regression, regression analysis, and restricted quadratic spline analysis, were employed to investigate the association between pesticides and mortality, chronic ailments, and inflammation. Furthermore, machine learning techniques, comprising RF, AdaBoost, Extra-Trees, LightGBM, and BPNN, were leveraged to evaluate the impact of pesticides on chronic disease and mortality prognostication.
    RESULTS: Organochlorine pesticides were significantly and positively correlated with increased mortality (p<0.05). Additionally, these pollutants were linked to the incidence of chronic diseases such as chronic kidney disease, diabetes, and hypertension (p< 0.05). Our study, utilizing various machine learning models, also showed a notable increase in the Area Under the Curve when incorporating organochlorine pesticide indicators into the model as opposed to excluding them. Furthermore, strong correlations were observed between serum c-reactive protein (CRP) and CRP to serum albumin ratio (CAR) concentrations with these substances, demonstrating their pro-inflammatory effects at specific concentrations. Interestingly, cutting down on dietary inflammation through changes in diet effectively reduced the risk of death at high organochlorine pesticide exposure levels, but the effect was less noticeable at low to moderate exposure levels.
    CONCLUSIONS: Exposure to organochlorine pesticides was linked to a higher risk of mortality, likely due to an increased prevalence of chronic diseases. In this context, inflammation played a crucial role, and adopting an anti-inflammatory diet significantly reduced the mortality risk associated with these pesticides.
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  • 文章类型: Journal Article
    背景:在患有慢性疾病的老年人中检测潜在的抑郁症并确定抑郁症的关键预测因子对于及时干预和管理抑郁症至关重要。因此,老年抑郁症的风险预测模型有待进一步探讨。
    方法:本研究纳入了来自中国健康和退休纵向研究(CHARLS)第四波调查的3959名60岁或以上的受访者。我们使用了五种机器学习(ML)算法和三种数据平衡技术来构建抑郁症的风险预测模型(RPM),并计算特征重要性得分以确定哪些特征对抑郁症至关重要。
    结果:在第四波调查中,中国老年慢性病患者的抑郁症患病率为19.2%。随机森林(RF)模型比其他模型更准确,平衡数据后使用合成少数过采样技术(SMOTE),受试者工作特征曲线下面积(AUROC)和精确召回曲线下面积(AUPRC)分别为0.957和0.920,0.891的平衡精度和0.875的灵敏度。此外,我们进一步确定了不同性别患者中的几个重要预测因素.
    结论:需要进一步研究我们的模型和外部验证的临床影响研究。
    结论:在使用了几种技术来解决类不平衡问题之后,大多数RPM在预测患有慢性病的老年人的抑郁方面取得了令人满意的准确性。因此,RPM可能成为老年人和医疗保健从业人员评估抑郁症风险的有价值的筛查工具。
    BACKGROUND: Detecting potential depression and identifying the critical predictors of depression among older adults with chronic diseases are essential for timely intervention and management of depression. Therefore, risk prediction models (RPMs) of depression in elderly people should be further explored.
    METHODS: A total of 3959 respondents aged 60 years or over from the wave four survey of the China Health and Retired Longitudinal Study (CHARLS) were included in this study. We used five machine learning (ML) algorithms and three data balancing techniques to construct RPMs of depression and calculated feature importance scores to determine which features are essential to depression.
    RESULTS: The prevalence of depression was 19.2 % among older Chinese adults with chronic diseases in the wave four survey. The random forest (RF) model was more accurate than the other models after balancing the data using the Synthetic Minority Oversampling Technique (SMOTE) algorithm, with an area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC) of 0.957 and 0.920, respectively, a balanced accuracy of 0.891 and a sensitivity of 0.875. Furthermore, we further identified several important predictors between male and female patients via constructed sex-stratified models.
    CONCLUSIONS: Further research on the clinical impact studies of our models and external validation are needed.
    CONCLUSIONS: After several techniques were used to address class imbalance issues, most RPMs achieved satisfactory accuracy in predicting depression among elderly people with chronic diseases. RPMs may thus become valuable screening tools for both older individuals and healthcare practitioners to assess the risk of depression.
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