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Open Access Original Article Issue
A Prediction Model for One‐Year Disability Risk Among Community‐Dwelling Older Adults in China: Integrating Physical, Metabolic, and Psychosocial Factors
Health Care Science 2026, 5(4): 320-329
Published: 17 May 2026
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Background

Disability in older adults, characterized by progressive limitations in performing activities of daily living, poses a significant public health challenge in aging societies. Early identification of individuals at risk is critical for implementing targeted interventions to mitigate functional decline. However, existing prediction models often prioritize disease‐related physiological indicators and overlook psychosocial dimensions, limiting their practicality and scalability in community‐based settings. This study aimed to develop and validate a practicable prediction model for 1‐year disability risk by integrating multidimensional indicators.

Methods

A prospective community‐based cohort in Beijing, functionally independent at baseline, was followed for 1 year. Disability was defined as a decline in the Barthel Index score. Potential predictors included demographic, lifestyle, clinical, physical, and psychosocial measures. The least absolute shrinkage and selection operator (LASSO) regression was used for variable selection, followed by logistic regression to construct the final model. Model performance was evaluated through fivefold cross‐validation repeated 100 times, with assessment of discrimination and calibration.

Results

Among 1003 community‐dwelling older adults (mean age 68.4 ± 5.2 years; 58.3% female), 163 (16.3%) developed disability at follow‐up. The LASSO regression identified seven predictors: age, dyslipidemia, gait speed, waist circumference, difficulty in lifting weights, appetite, and emotion regulation ability. The model demonstrated moderate discrimination, with an area under the receiver operating characteristic curve of 0.716 (95% CI: 0.712–0.720). Calibration curves indicated good overall agreement between predicted and observed risks. A nomogram was developed to facilitate individualized risk prediction in clinical practice.

Conclusions

This study presents a practical disability risk prediction model incorporating physical, metabolic, and psychosocial factors. The model exhibits acceptable discrimination and calibration, supporting its potential for early screening and stratified management of community‐dwelling older adults. Future multicenter validations are warranted to enhance generalizability and explore dynamic interventions targeting modifiable factors like emotion regulation and gait speed.

Open Access Research Article Issue
Deep Learning for Classifying and Cognitive Profiling of Subcortical Vascular Cognitive Impairment
Cyborg and Bionic Systems 2026, 7: 0561
Published: 13 May 2026
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Subcortical vascular cognitive impairment (SVCI) is a heterogeneous cognitive impairment caused by small vessel disease. Diagnosis of SVCI remains challenging when neuropsychological assessment is impractical. This study proposes a diffusion tensor imaging (DTI)-based DenseNet to identify SVCI from subcortical ischemic vascular disease (SIVD) and to profile multidomain cognitive risks. We collected neuropsychological scales and DTI from 134 SVCI and 171 SIVD patients in our internal dataset for model development. An external target-domain dataset of 90 SVCI and 103 SIVD patients was used for unsupervised domain adaptation (UDA). Within this dataset, 45 SVCI and 53 SIVD patients were used for unlabeled UDA fitting; the remaining 45 SVCI and 50 SIVD patients were held out as a target-domain test set. Model-generated salient maps identified white matter (WM) regions associated with SVCI. Mutual information (MI) maps between DTI and 6 neuropsychological scales were computed to identify structural correlates of cognitive domains for cognitive profiling. We computed structural similarity index measure (SSIM) between individual-level salient maps derived from DenseNet and the MI maps for unsupervised clustering to stratify domain-specific cognitive impairment risk in SVCI. The DenseNet achieves high accuracy (0.902 internal, 0.926 target-domain) with AUCs of 0.951 and 0.942, respectively. SVCI probabilities reflect cognitive severity, and salient maps are associated with neuropsychological performance. Regarding cognitive profiling, each cognitive domain is divided into low, moderate, and high subgroups, with significantly different SSIM. Our DTI-based study demonstrates accurate SVCI identification and individualized multi-domain cognitive profiling. This offers a complementary framework to support diagnosis and personalized intervention.

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