Comparative study on the predictive efficacy of different intrinsic ability scoring methods for functional impairment in elderly people
10.3760/cma.j.cn115682-20250128-00460
- VernacularTitle:不同内在能力评分方法对老年人功能障碍预测效能的对比研究
- Author:
Mengzhuo LIU
1
;
Ying WU
1
Author Information
1. 首都医科大学护理学院，北京 100069
- Publication Type:Journal Article
- Keywords:
Aged;
Intrinsic ability;
Scoring methods;
Functional impairment;
Predictive efficacy
- From:
Chinese Journal of Modern Nursing
2025;31(15):2005-2013
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and compare the predictive value of four different intrinsic ability scoring methods for functional impairment in elderly people and to provide scientific evidence for selecting the appropriate scoring method.Methods:Based on data from the China Health and Retirement Longitudinal Study, 1 844 elderly individuals were included and grouped according to their functional status. Univariate analysis and binary Logistic regression were used to construct a basic prediction model for functional impairment in elderly people. On the basis of the basic model, intrinsic ability scores calculated using four different scoring methods were added to construct four extended prediction models. Receiver operating characteristic curves were plotted, and DeLong tests were conducted to compare the area under the curve ( AUC) of the different prediction models. Calibration curves and clinical decision curves were used to evaluate the prediction efficacy of the four intrinsic ability scoring methods for functional impairment in elderly people. Results:The functional impairment incidence in the 1 844 elderly individuals was 22.99% (424/1 844). The AUC of the basic functional impairment prediction model was 65.36%. The extended prediction models based on the Z-score method, dimensional reduction method, direct summation method, and factor analysis method showed improved predictive efficacy, with AUC increasing by 3.87% ( P<0.001), 1.73% ( P=0.007), 3.86% ( P<0.001), and 3.08% ( P<0.001), respectively. The direct summation method and Z-score method showed better predictive efficacy for functional impairment in elderly people, with no statistically significant difference between the two methods ( P>0.05). Calibration and clinical decision curves indicated that all four scoring methods had good calibration ability and clinical utility in predicting functional impairment. Conclusions:All four intrinsic ability scoring methods can improve the predictive efficacy and clinical utility of functional impairment in elderly people to varying degrees. The direct summation method and Z-score method show better predictive efficacy, followed by factor analysis, with the dimensional reduction method showing the lowest efficacy. Due to its simplicity in operation, the direct summation method is suitable for clinical application.
