关键词: 老年人, 认知衰弱, 危险因素, 列线图, 预测模型, 社区保健护理

Abstract:

Objective To establish and validate a risk prediction model for cognitive frailty in community elderly. Methods 526 elderly people taking physical examinations were recruited in a community health service center in Guangzhou by convenience sampling from August 2020 to July 2021. They were divided into a modeling group （368 cases） and a validation group（158 cases）. Data were collected by a general information questionnaire and cognitive frailty assessment tools. Logistic regression was used to determine the influencing factors,and R software was used to establish a nomogram model for predicting the risk of cognitive frailty. Bootstrap method was used for internal validation of the model,and the validation group was used for external validation. C statistic and calibration curve were used to evaluate the prediction performance of the model. Results The model variables included IADL,self-rated health,daytime mental state,the number of chronic diseases,age,nutritional status and physical exercise. The AUROC of the model was 0.920（95%CI：0.892~0.947）,the best cutoff value was 0.401;the sensitivity was 79.7%;the specificity was 89.1%;The C statistics of internal and external validation were 0.910 （95%CI：0.863~0.936） and 0.850（95%CI：0.785~0.915）,respectively;calibration curve and Brier score showed good fit. Conclusion The prediction model has a good degree of discrimination and calibration,which can intuitively and easily screen the elderly at high risk of cognitive frailty in the community,and provide references for early screening and intervention.

Key words: Aged, Cognitive Frailty, Risk Factors, Nomograms, Prediction Model, Community Health Nursing