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. 2024 Jul 4:16:1376693.
doi: 10.3389/fnagi.2024.1376693. eCollection 2024.

A glimpse into the future: revealing the key factors for survival in cognitively impaired patients

Libing Wei #  1 , Dikang Pan #  1 , Sensen Wu  1 , Hui Wang  1 , Jingyu Wang  2 , Lianrui Guo  1 , Yongquan Gu  1
Affiliations

A glimpse into the future: revealing the key factors for survival in cognitively impaired patients

Libing Wei et al. Front Aging Neurosci. .

Abstract

Background: Drawing on prospective data from the National Health and Nutrition Examination Survey (NHANES), our goal was to construct and validate a 5-year survival prediction model for individuals with cognitive impairment (CI).

Methods: This study entailed a prospective cohort design utilizing information from the 2011-2014 NHANES dataset, encompassing individuals aged 40 years or older, with updated mortality status as of December 31, 2019. Predictive models within the derivation and validation cohorts were assessed using logistic proportional risk regression, column-line plots, and least absolute shrinkage and selection operator (LASSO) binomial regression models.

Results: The study enrolled a total of 1,439 participants (677 men, mean age 69.75 ± 6.71 years), with the derivation and validation cohorts consisting of 1,007 (538 men) and 432 (239 men) individuals, respectively. The 5-year mortality rate stood at 16.12% (n = 232). We devised a 5-item column-line graphical model incorporating age, race, stroke, cardiovascular disease (CVD), and blood urea nitrogen (BUN). The model exhibited an area under the curve (AUC) of 0.772 with satisfactory calibration. Internal validation demonstrated that the column-line graph model displayed strong discrimination, yielding an AUC of 0.733, and exhibited good calibration.

Conclusion: To sum up, our study successfully developed and internally validated a 5-item nomogram integrating age, race, stroke, cardiovascular disease, and blood urea nitrogen. This nomogram exhibited robust predictive performance for 5-year mortality in individuals with CI, offering a valuable tool for prognostic evaluation and personalized care planning.

Keywords: NHANES; cognitive impairment; mortality; nomogram; prospective studies.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Framework diagram of the study.
Figure 2
Figure 2
Low chart for participant screening.
Figure 3
Figure 3
(A) LASSO regression coefficient path plot. (B) LASSO regression cross-validation plot.
Figure 4
Figure 4
Nomogram prediction model.
Figure 5
Figure 5
ROC curves of the nomogram prediction model. (A) Training set ROC curve. (B) Internal validation set ROC curve.
Figure 6
Figure 6
Calibration curves. (A) training cohort, (B) internal test cohort.
Figure 7
Figure 7
Decision curve analysis, (A) training cohort, (B) internal test cohort.
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Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from National Key Research and Development Program of China (No. 2021YFC2500500). The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

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