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Qiu Y, Ma X. Using machine learning models to identify the risk of depression in middle-aged and older adults with frequent and infrequent nicotine use: A cross-sectional study. J Affect Disord 2024; 367:554-561. [PMID: 39222853 DOI: 10.1016/j.jad.2024.08.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/04/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Depression is very prevalent in middle-aged and older smokers. Therefore, we aimed to identify the risk of depression among middle-aged and older adults with frequent and infrequent nicotine use, as this is quite necessary for supporting their well-being. METHODS This study included a total of 10,821 participants, which were derived from the China Health and Retirement Longitudinal Study Wave 5, 2020 (CHARLS-5). Five machine learning (ML) algorithms were employed. Some metrics were used to evaluate the performance of models, including area under the receiver operating characteristic curve (AUC), positive predictive value (PPV), specificity, accuracy. RESULTS 10,821 participants (6472 males, 4349 females) had a mean age of 60.47 ± 8.98, with a score of 8.90 ± 6.53 on depression scale. For middle-aged and older adults with frequent nicotine use, random forest (RF) achieved the highest AUC value, PPV and specificity (0.75, 0.74 and 0.88, respectively). For the other group, support vector machines (SVM) showed the highest PPV (0.74), and relatively high accuracy and specificity (0.72 and 0.87, respectively). Feature importance analysis indicated that "dissatisfaction with life" was the most important variable of identifying the risk of depression in the SVM model, while "attitude towards expected life span" was the most important one in the RF model. LIMITATIONS CHARLS-5 was collected during the COVID-19, so our results may be influenced by the pandemic. CONCLUSIONS This study indicated that certain ML models can ideally identify the risk of depression in middle-aged and older adults, which holds significant value for their health management.
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Affiliation(s)
- Yuran Qiu
- Department of Psychology, Henan University, Kaifeng, China.
| | - Xu Ma
- Beijing Anding Hospital, Capital Medical University, Beijing, China
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Xiong LY, Wood Alexander M, Cogo-Moreira H, Wu CY, Eid M, Herrmann N, Gallagher D, Edwards JD, Lanctôt KL, Marzolini S, Bennett DA, Rabin JS, Swardfager W. Longitudinal relationships between depressive symptoms, functional impairment, and physical activity in later late life. GeroScience 2024:10.1007/s11357-024-01282-1. [PMID: 39023667 DOI: 10.1007/s11357-024-01282-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024] Open
Abstract
The purpose of this study was to investigate relationships between depressive symptoms, functional disability, and physical activity over time in community-dwelling older adults. The Religious Order Study and Rush Memory and Aging Project are longitudinal cohort studies based in the United States which began recruitment in 1994 and 1997, respectively. This analysis included 1611 participants (27.4% male, 92.9% White, 74.7% cognitively normal) who were included at age 80 and followed until age 90. Depressive symptoms were assessed using the modified Center for Epidemiologic Studies Depression scale. Functional disability was assessed using the Instrumental Activities of Daily Living (IADL) scale. Physical activity was self-reported hours of weekly exercise. Reciprocal temporal relationships between these variables were investigated using a random intercept cross-lagged panel model, which decomposes observed variables into stable between-person ('trait') and variable within-person ('state') components to estimate the directional effects between variables over time. Traits for depressive symptoms, IADL disability, and physical activity were correlated. IADL disability showed autoregressive effects; disability starting at age 82 strongly predicted subsequent disability. Consistent autoregressive effects were not observed for depressive symptoms nor physical activity. Several small cross-lagged effects between states were observed for IADL disability and physical activity, as well as for IADL disability and depressive symptoms. There were no direct effects between depressive symptoms and physical activity, but several paths through IADL disability were observed between ages 82 and 88. Functional disability played an important role in octogenarians, highlighting the importance of maintaining functional independence later in life.
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Affiliation(s)
- Lisa Y Xiong
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | - Madeline Wood Alexander
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Hugo Cogo-Moreira
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Che-Yuan Wu
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | - Michael Eid
- Department of Educational Science and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Damien Gallagher
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Jodi D Edwards
- University of Ottawa Heart Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- ICES, Ottawa, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Susan Marzolini
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Jennifer S Rabin
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Walter Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada.
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada.
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
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Buchan MC, Romano I, Butler A, Laxer RE, Patte KA, Leatherdale ST. Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study. Int J Behav Nutr Phys Act 2021; 18:132. [PMID: 34627283 PMCID: PMC8501578 DOI: 10.1186/s12966-021-01201-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this research was to examine the bidirectional association between self-reported symptoms of mental disorder and physical activity among a large sample of Canadian secondary school students over time. METHODS Linked survey data were obtained from 28,567 grade 9 to 12 students across Canada participating in two waves of the COMPASS Study (2017-18; 2018-19). Autoregressive cross-lagged models were run to examine the reciprocal relationships between self-reported moderate-to-vigorous physical activity (MVPA) and symptoms of depression (CESD-10) and anxiety (GAD-7). Models were stratified by gender, and accounted for grade, ethno-racial identity, and school-level clustering. RESULTS Autoregressive associations show that neither symptoms of anxiety nor depression, at baseline, were predictive of mean MVPA at follow-up - consistent for the full sample and among both males and females. Higher MVPA among males at baseline was associated with lower symptoms of both anxiety (β = - 0.03, p = 0.002) and depression (β = - 0.05, p < 0.001) at follow-up. However, among females, higher MVPA at baseline was associated with greater symptoms of anxiety (β = 0.03, p < 0.001), but not symptoms of depression (β = 0.01, p = 0.073), at follow-up. CONCLUSION In our large sample of Canadian secondary school students, associations between physical activity and symptoms of mental disorder were not bi-directional, and these relationships differed in males and females. This study illustrates the complex nature of the relationship between physical activity and symptoms of mental disorder among youth. While results support the benefits of promoting physical activity among males to prevent or manage internalizing symptoms, the relationship among females warrants further investigation.
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Affiliation(s)
- M Claire Buchan
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Isabella Romano
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Alexandra Butler
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | | | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
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Raatikainen I, Mäntyselkä P, Heinonen A, Vanhala M, Kautiainen H, Koponen H, Korniloff K. Does baseline leisure-time physical activity level predict future depressive symptoms or physical activity among depressive patients? Findings from a Finnish five-year cohort study. Nord J Psychiatry 2021; 75:356-361. [PMID: 33380252 DOI: 10.1080/08039488.2020.1862296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aims of this study were to investigate whether baseline leisure-time physical activity (LTPA) is associated with future recovery from depression among patients with a depression diagnosis and whether baseline LTPA is associated with total physical activity after five years of follow-up. METHODS A total of 258 patients aged ≥35 years with clinically confirmed depression at baseline participated. The study was conducted between 2008 and 2016 in municipalities within the Central Finland Hospital District. Depressive symptoms (DS) were determined with the Beck Depression Inventory (BDI) with a cutoff score ≥10, and depression diagnoses were confirmed by the Mini-International Neuropsychiatric Interview (MINI). Blood pressure and anthropometric parameters were measured and blood samples for glucose and lipid determinations were drawn at baseline. LTPA, physical activity, and other social and clinical factors were captured by standard self-administered questionnaires at baseline and the five-year follow-up point. RESULTS Of the 258 patients, 76 (29%) had DS at follow-up. Adjusted odds ratio (OR) for future DS was 1.43 (confidence interval [CI] 0.69-2.95) for participants with moderate LTPA and 0.92 (CI 0.42-2.00) for participants with high LTPA, compared with low LTPA at baseline. Higher baseline LTPA levels were associated with higher total physical activity in the future (β=0.14 [95% CI: 0.02-0.26] for linearity = 0.024). CONCLUSION Baseline LTPA did not affect the five-year prognosis of depression among depressed patients in a Finnish adult population. Because the baseline LTPA level predicted the future total physical activity, it could be included as a part of the overall health management and treatment of depression in clinical practices.
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Affiliation(s)
- Ilkka Raatikainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Assistive Technology Centre, Central Finland Health Care District, Jyväskylä, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mauno Vanhala
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Hannu Koponen
- Old Age Psychiatry, Department of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Katariina Korniloff
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
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van den Berg KS, Hegeman JM, van den Brink RHS, Rhebergen D, Oude Voshaar RC, Marijnissen RM. A prospective study into change of vitamin D levels, depression and frailty among depressed older persons. Int J Geriatr Psychiatry 2021; 36:1029-1036. [PMID: 33559131 PMCID: PMC8248246 DOI: 10.1002/gps.5507] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/31/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES While vitamin D is involved in frailty as well as depression, hardly any study has examined the course of vitamin D levels prospectively. The objective of this study is to examine whether a change of vitamin D in depressed older adults is associated with either depression course, course of frailty, or both. METHODS The study population consisted of 232 of 378 older adults (60-93 years) with a DSM-IV defined depressive disorder participating in the Netherlands Study of Depression in Older persons, a prospective clinical cohort study. Baseline and 2-year follow-up data on depressive disorder (DSM-IV diagnosis), symptom severity (inventory of depressive symptoms), frailty phenotype (and its individual components) and vitamin D levels were obtained. Linear mixed models were used to study the association of change in vitamin D levels with depression course, course of frailty, and the combination. RESULTS Vitamin D levels decreased from baseline to follow-up, independent from depression course. An increase in frailty was associated with a significantly sharper decrease of vitamin D levels over time. Post hoc analyses showed that this association with frailty might be driven by an increase of exhaustion over time and counteracted by an increase in walking speed. CONCLUSIONS Our findings generate the hypothesis that vitamin D supplementation in late-life depression may improve frailty, which may partly explain inconsistent findings of randomised controlled trials evaluating the effect of vitamin D for depression. We advocate to consider frailty (components) as an outcome in future supplementation trials in late-life depression.
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Affiliation(s)
- Karen S. van den Berg
- Department of PsychiatrySt Antonius HospitalNieuwegein/UtrechtThe Netherlands,Department of PsychiatryUniversity Centre of PsychiatryUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Johanna M. Hegeman
- Department of PsychiatrySt Antonius HospitalNieuwegein/UtrechtThe Netherlands
| | - Rob H. S. van den Brink
- Department of PsychiatryUniversity Centre of PsychiatryUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Didi Rhebergen
- Department of PsychiatryVU University Medical Centre/GGZ InGeestAmsterdamThe Netherlands
| | - Richard C. Oude Voshaar
- Department of PsychiatryUniversity Centre of PsychiatryUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Radboud M. Marijnissen
- Department of PsychiatryUniversity Centre of PsychiatryUniversity Medical Centre GroningenGroningenThe Netherlands
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Su D, Zhang X, He K, Chen Y. Use of machine learning approach to predict depression in the elderly in China: A longitudinal study. J Affect Disord 2021; 282:289-298. [PMID: 33418381 DOI: 10.1016/j.jad.2020.12.160] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/28/2020] [Accepted: 12/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Early detection of potential depression among elderly people is conducive for timely preventive intervention and clinical care to improve quality of life. Therefore, depression prediction considering sequential progression patterns in elderly needs to be further explored. METHODS We selected 1,538 elderly people from Chinese Longitudinal Healthy Longevity Study (CLHLS) wave 3-7 survey. Long short-term memory (LSTM) and six machine learning (ML) models were used to predict different depression risk factors and the depression risks in the elderly population in the next two years. Receiver operating curve (ROC) and decision curve analysis (DCA) were used to evaluate the prediction accuracy of the reference model and ML models. RESULTS The area under the ROC curve (AUC) values of logistic regression with lasso regularisation (AUC=0.629, p-value=0.020) was the highest among ML models. DCA results showed that the net benefit of six ML models was similar (threshold: 0.00-0.10), the net benefit of lasso regression was the largest (threshold: 0.10-0.17 and 0.22-0.25), and the net benefit of DNN was the largest (threshold: 0.17-0.22 and 0.25-0.40). In two ML models, activities of daily living (ADL)/ instrumental ADL (IADL), self-rated health, marital status, arthritis, and number of cohabiting were the most important predictors for elderly with depression. LIMITATIONS The retrospective waves used in the LSTM model need to be further increased. CONCLUSION The decision support system based on the proposed LSTM+ML model may be very valuable for doctors, nurses and community medical providers for early diagnosis and intervention.
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Affiliation(s)
- Dai Su
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, China; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, USA
| | - Xingyu Zhang
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, USA
| | - Kevin He
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, USA
| | - Yingchun Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, China.
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