Machine Learning Applications in Sarcopenia Detection and Management: A Comprehensive Survey

Comparative study of imputation strategies to improve the sarcopenia prediction task

Objective

Sarcopenia, a condition characterized by the progressive loss of skeletal muscle mass and strength, poses significant challenges in research due to missing data. Incomplete datasets undermine the accuracy and reliability of studies, necessitating effective imputation techniques. This study conducts a comparative analysis of three advanced methods-multiple imputation by chained equations (MICE), support vector regression, and K-nearest neighbors (KNN)-to address data completeness issues in sarcopenia research.

Methods

Following imputation, we utilized machine learning models, including logistic regression, gradient boosting, support vector machine, and random forest, to classify sarcopenia. The methodology encompassed rigorous data preprocessing, normalization, and the synthetic minority oversampling technique to address class imbalance and ensure unbiased model performance.

Results

The results revealed substantial variations in model accuracy based on the imputation method employed. The gradient boosting model consistently exhibited superior performance across all imputation strategies, demonstrating its robustness with imputed datasets. Additionally, KNN and MICE emerged as effective imputation techniques, preserving the original data distribution and enabling more accurate classification outcomes.

Conclusion

This study underscores the pivotal role of imputation methods in maintaining data integrity and enhancing predictive accuracy in sarcopenia research. The gradient boosting model's reliability across all strategies highlights its potential as a robust classifier, while the suitability of KNN and MICE for preserving data distribution supports their application in similar research contexts. These findings contribute to more reliable and valid insights in sarcopenia studies, ultimately supporting improved clinical outcomes.

Exploring determinant factors influencing muscle quality and sarcopenia in Bilbao's older adult population through machine learning: A comprehensive analysis approach

BACKGROUND

Sarcopenia and reduced muscle quality index have garnered special attention due to their prevalence among older individuals and the adverse effects they generate. Early detection of these geriatric pathologies holds significant potential, enabling the implementation of interventions that may slow or reverse their progression, thereby improving the individual's overall health and quality of life. In this context, artificial intelligence opens up new opportunities to identify the key identifying factors of these pathologies, thus facilitating earlier intervention and personalized treatment approaches.

OBJECTIVES

investigate anthropomorphic, functional, and socioeconomic factors associated with muscle quality and sarcopenia using machine learning approaches and identify key determinant factors for their potential future integration into clinical practice.

METHODS

A total of 1253 older adults (89.5% women) with a mean age of 78.13 ± 5.78 voluntarily participated in this descriptive cross-sectional study, which examines determining factors in sarcopenia and MQI using machine learning techniques. Feature selection was completed using a variety of techniques and feature datasets were constructed according to feature selection. Three machine learning classification algorithms classified sarcopenia and MQI in each dataset, and the performance of classification models was compared.

RESULTS

The predictive models used in this study exhibited AUC scores of 0.7671 for MQI and 0.7649 for sarcopenia, with the most successful algorithms being SVM and MLP. Key factors in predicting both conditions have been shown to be relative power, age, weight, and the 5STS. No single factor is sufficient to predict either condition, and by comprehensively considering all selected features, the study underscores the importance of a holistic approach in understanding and addressing sarcopenia and MQI among older adults.

CONCLUSIONS

Exploring the factors that affect sarcopenia and MQI in older adults, this study highlights that relative power, age, weight, and the 5STS are significant determinants. While considering these clinical markers and using a holistic approach, this can provide crucial information for designing personalized and effective interventions to promote healthy aging.

Wearable Fabric System for Sarcopenia Detection

Sarcopenia has been a serious concern in the context of an increasingly aging global population. Existing detection methods for sarcopenia are severely constrained by cumbersome devices, the necessity for specialized personnel, and controlled experimental environments. In this study, we developed an innovative wearable fabric system based on conductive fabric and flexible sensor array. This fabric system demonstrates remarkable pressure-sensing capabilities, with a high sensitivity of 18.8 kPa-1 and extraordinary stability. It also exhibits excellent flexibility for wearable applications. By interacting with different parts of the human body, it facilitates the monitoring of various physiological activities, such as pulse dynamics, finger movements, speaking, and ambulation. Moreover, this fabric system can be seamlessly integrated into sole to track critical indicators of sarcopenia patients, such as walking speed and gait. Clinical evaluations have shown that this fabric system can effectively detect variations in indicators relevant to sarcopenia patients, proving that it offers a straightforward and promising approach for the diagnosis and assessment of sarcopenia.

Sarcopenia diagnosis using skeleton-based gait sequence and foot-pressure image datasets

Introduction

Sarcopenia is a common age-related disease, defined as a decrease in muscle strength and function owing to reduced skeletal muscle. One way to diagnose sarcopenia is through gait analysis and foot-pressure imaging.

Motivation and research gap

We collected our own multimodal dataset from 100 subjects, consisting of both foot-pressure and skeleton data with real patients, which provides a unique resource for future studies aimed at more comprehensive analyses. While artificial intelligence has been employed for sarcopenia detection, previous studies have predominantly focused on skeleton-based datasets without exploring the combined potential of skeleton and foot pressure dataset. This study conducts separate experiments for foot-pressure and skeleton datasets, it demonstrates the potential of each data type in sarcopenia classification.

Methods

This study had two components. First, we collected skeleton and foot-pressure datasets and classified them into sarcopenia and non-sarcopenia groups based on grip strength, gait performance, and appendicular skeletal muscle mass. Second, we performed experiments on the foot-pressure dataset using the ResNet-18 and spatiotemporal graph convolutional network (ST-GCN) models on the skeleton dataset to classify normal and abnormal gaits due to sarcopenia. For an accurate diagnosis, real-time walking of 100 participants was recorded at 30 fps as RGB + D images. The skeleton dataset was constructed by extracting 3D skeleton information comprising 25 feature points from the image, whereas the foot-pressure dataset was constructed by exerting pressure on the foot-pressure plates.

Results

As a baseline evaluation, the accuracies of sarcopenia classification performance from foot-pressure image using Resnet-18 and skeleton sequences using ST-GCN were identified as 77.16 and 78.63%, respectively.

Discussion

The experimental results demonstrated the potential applications of sarcopenia and non-sarcopenia classifications based on foot-pressure images and skeleton sequences.

Sarcopenia screening based on the assessment of gait with inertial measurement units: a systematic review

BACKGROUND

Gait variables assessed by inertial measurement units (IMUs) show promise as screening tools for aging-related diseases like sarcopenia. The main aims of this systematic review were to analyze and synthesize the scientific evidence for screening sarcopenia based on gait variables assessed by IMUs, and also to review articles that investigated which gait variables assessed by IMUs were related to sarcopenia.

METHODS

Six electronic databases (PubMed, SportDiscus, Web of Science, Cochrane Library, Scopus and IEEE Xplore) were searched for journal articles related to gait, IMUs and sarcopenia. The search was conducted until December 5, 2023. Titles, abstracts and full-length texts for studies were screened to be included.

RESULTS

A total of seven articles were finally included in this review. Despite some methodological variability among the included studies, IMUs demonstrated potential as effective tools for detecting sarcopenia when coupled with artificial intelligence (AI) models, which outperformed traditional statistical methods in classification accuracy. The findings suggest that gait variables related to the stance phase such as stance duration, double support time, and variations between feet, are key indicators of sarcopenia.

CONCLUSIONS

IMUs could be useful tools for sarcopenia screening based on gait analysis, specifically when artificial intelligence is used to process the recorded data. However, more development and research in this field is needed to provide an effective screening tool for doctors and health systems.

Early Poplar (Populus) Leaf-Based Disease Detection through Computer Vision, YOLOv8, and Contrast Stretching Technique

Poplar (Populus) trees play a vital role in various industries and in environmental sustainability. They are widely used for paper production, timber, and as windbreaks, in addition to their significant contributions to carbon sequestration. Given their economic and ecological importance, effective disease management is essential. Convolutional Neural Networks (CNNs), particularly adept at processing visual information, are crucial for the accurate detection and classification of plant diseases. This study introduces a novel dataset of manually collected images of diseased poplar leaves from Uzbekistan and South Korea, enhancing the geographic diversity and application of the dataset. The disease classes consist of "Parsha (Scab)", "Brown-spotting", "White-Gray spotting", and "Rust", reflecting common afflictions in these regions. This dataset will be made publicly available to support ongoing research efforts. Employing the advanced YOLOv8 model, a state-of-the-art CNN architecture, we applied a Contrast Stretching technique prior to model training in order to enhance disease detection accuracy. This approach not only improves the model's diagnostic capabilities but also offers a scalable tool for monitoring and treating poplar diseases, thereby supporting the health and sustainability of these critical resources. This dataset, to our knowledge, will be the first of its kind to be publicly available, offering a valuable resource for researchers and practitioners worldwide.

Using Flexible-Printed Piezoelectric Sensor Arrays to Measure Plantar Pressure during Walking for Sarcopenia Screening

Sarcopenia is an age-related syndrome characterized by the loss of skeletal muscle mass and function. Community screening, commonly used in early diagnosis, usually lacks features such as real-time monitoring, low cost, and convenience. This study introduces a promising approach to sarcopenia screening by dynamic plantar pressure monitoring. We propose a wearable flexible-printed piezoelectric sensing array incorporating barium titanate thin films. Utilizing a flexible printer, we fabricate the array with enhanced compressive strength and measurement range. Signal conversion circuits convert charge signals of the sensors into voltage signals, which are transmitted to a mobile phone via Bluetooth after processing. Through cyclic loading, we obtain the average voltage sensitivity (4.844 mV/kPa) of the sensing array. During a 6 m walk, the dynamic plantar pressure features of 51 recruited participants are extracted, including peak pressures for both sarcopenic and control participants before and after weight calibration. Statistical analysis discerns feature significance between groups, and five machine learning models are employed to screen for sarcopenia with the collected features. The results show that the features of dynamic plantar pressure have great potential in early screening of sarcopenia, and the Support Vector Machine model after feature selection achieves a high accuracy of 93.65%. By combining wearable sensors with machine learning techniques, this study aims to provide more convenient and effective sarcopenia screening methods for the elderly.

Identifying factors associated with locomotive syndrome using machine learning methods: The third survey of the research on osteoarthritis/osteoporosis against disability study

AIM

To identify factors associated with locomotive syndrome (LS) using medical questionnaire data and machine learning.

METHODS

A total of 1575 participants underwent the LS risk tests from the third survey of the research on osteoarthritis/osteoporosis against disability study (ROAD) study. LS was defined as stage 1 or higher based on clinical decision limits of the Japanese Orthopaedic Association. A total of 1335 items of medical questionnaire data came from this study. The number of medical questionnaire items was reduced from 1335 to 331 in data cleaning. From the 331 items, identify factors associated with LS use by light gradient boosting machine-based recursive feature elimination with cross-validation. The performance of each set was evaluated using an average of seven performance metrics, including 95% confidence intervals, using a bootstrapping method. The smallest set of items is determined with the highest average of receiver operating characteristic area under the curve (ROC-AUC) under 20 items as association factors of LS. Additionally, the performance of the selected items was compared with the LS risk tests and Loco-check.

RESULTS

The nine items have the best average ROC-AUC under 20 items. The nine items show an average ROC-AUC of 0.858 (95% confidence interval 0.816-0.898). Age and back pain during walking were strongly associated with the prevalence of LS. The ROC-AUC of nine items is higher than that of existing questionnaire-based LS assessments, including the 25-question Geriatric Locomotor Scale and Loco-check.

CONCLUSIONS

The identified nine items could aid early LS detection, enhancing understanding and prevention. Geriatr Gerontol Int 2024; 24: 806-813.

Exploration of a machine learning approach for diagnosing sarcopenia among Chinese community-dwelling older adults using sEMG-based data

BACKGROUND

In the practical application of sarcopenia screening, there is a need for faster, time-saving, and community-friendly detection methods. The primary purpose of this study was to perform sarcopenia screening in community-dwelling older adults and investigate whether surface electromyogram (sEMG) from hand grip could potentially be used to detect sarcopenia using machine learning (ML) methods with reasonable features extracted from sEMG signals. The secondary aim was to provide the interpretability of the obtained ML models using a novel feature importance estimation method.

METHODS

A total of 158 community-dwelling older residents (≥ 60 years old) were recruited. After screening through the diagnostic criteria of the Asian Working Group for Sarcopenia in 2019 (AWGS 2019) and data quality check, participants were assigned to the healthy group (n = 45) and the sarcopenic group (n = 48). sEMG signals from six forearm muscles were recorded during the hand grip task at 20% maximal voluntary contraction (MVC) and 50% MVC. After filtering recorded signals, nine representative features were extracted, including six time-domain features plus three time-frequency domain features. Then, a voting classifier ensembled by a support vector machine (SVM), a random forest (RF), and a gradient boosting machine (GBM) was implemented to classify healthy versus sarcopenic participants. Finally, the SHapley Additive exPlanations (SHAP) method was utilized to investigate feature importance during classification.

RESULTS

Seven out of the nine features exhibited statistically significant differences between healthy and sarcopenic participants in both 20% and 50% MVC tests. Using these features, the voting classifier achieved 80% sensitivity and 73% accuracy through a five-fold cross-validation. Such performance was better than each of the SVM, RF, and GBM models alone. Lastly, SHAP results revealed that the wavelength (WL) and the kurtosis of continuous wavelet transform coefficients (CWT_kurtosis) had the highest feature impact scores.

CONCLUSION

This study proposed a method for community-based sarcopenia screening using sEMG signals of forearm muscles. Using a voting classifier with nine representative features, the accuracy exceeds 70% and the sensitivity exceeds 75%, indicating moderate classification performance. Interpretable results obtained from the SHAP model suggest that motor unit (MU) activation mode may be a key factor affecting sarcopenia.

Metaheuristic-Based Feature Selection Methods for Diagnosing Sarcopenia with Machine Learning Algorithms

This study explores the efficacy of metaheuristic-based feature selection in improving machine learning performance for diagnosing sarcopenia. Extraction and utilization of features significantly impacting diagnosis efficacy emerge as a critical facet when applying machine learning for sarcopenia diagnosis. Using data from the 8th Korean Longitudinal Study on Aging (KLoSA), this study examines harmony search (HS) and the genetic algorithm (GA) for feature selection. Evaluation of the resulting feature set involves a decision tree, a random forest, a support vector machine, and naïve bayes algorithms. As a result, the HS-derived feature set trained with a support vector machine yielded an accuracy of 0.785 and a weighted F1 score of 0.782, which outperformed traditional methods. These findings underscore the competitive edge of metaheuristic-based selection, demonstrating its potential in advancing sarcopenia diagnosis. This study advocates for further exploration of metaheuristic-based feature selection's pivotal role in future sarcopenia research.

Machine Learning for Sarcopenia Prediction in the Elderly Using Socioeconomic, Infrastructure, and Quality-of-Life Data

Since the WHO's 2021 aging redefinition emphasizes "healthy aging" by focusing on the elderly's ability to perform daily activities, sarcopenia, which is defined as the loss of skeletal muscle mass, is now becoming a critical health concern, especially in South Korea with a rapidly aging population. Therefore, we develop a prediction model for sarcopenia by using machine learning (ML) techniques based on the Korea National Health and Nutrition Examination Survey (KNHANES) data 2008-2011, in which we focus on the role of socioeconomic status (SES), social infrastructure, and quality of life (QoL) in the prevalence of sarcopenia. We successfully identify sarcopenia with approximately 80% accuracy by using random forest (RF) and LightGBM (LGB), CatBoost (CAT), and a deep neural network (DNN). For prediction reliability, we achieve area under curve (AUC) values of 0.831, 0.868, and 0.773 for both genders, males, and females, respectively. Especially when using only male data, all the models consistently exhibit better performance overall. Furthermore, using the SHapley Additive exPlanations (SHAP) analysis, we find several common key features, which mainly contribute to model building. These include SES features, such as monthly household income, housing type, marriage status, and social infrastructure accessibility. Furthermore, the causal relationships of household income, per capita neighborhood sports facility area, and life satisfaction are analyzed to establish an effective prediction model for sarcopenia management in an aging population.