Lee Mi Jung, Kim Daejin, Bian Jiang, Romero Sergio, Bliznyuk Nikolay
Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch at Galveston, Galveston, TX, USA.
Department of Interior Design, Iowa State University, Ames, IA, USA.
Arch Gerontol Geriatr. 2024 Jan;116:105149. doi: 10.1016/j.archger.2023.105149. Epub 2023 Aug 2.
This study aimed to identify demographic and housing features associated with functional difficulties experienced by older adults in their homes.
Individuals aged ≥ 65 years who completed American Housing Survey (AHS) questionnaires. We selected one random person per household and excluded participants with missing data for the 12 AHS functional challenge items.
Multiple machine learning models were compared to identify the best-performing model, which was then used to analyze the impact of demographic and housing features on older adults' functional difficulties at home.
The random forest model was selected for its preferred predictive performance (accuracy: 85.8%, sensitivity: 94.4%, specificity: 60.2%, precision: 87.6%, and negative predictive value: 78.2%). The top five variables that significantly influenced the model were: 1) walking disability, 2) presence or use of a cane or walker, 3) presence or use of handrails or grab bars in the bathroom, 4) go-outside-home disability, and 5) self-care disability. These variables had a stronger impact on the model than the householder's health and age.
Home modifications and environmental adaptations may be critical in enhancing functional abilities and independence among older adults. These findings could inform the development of interventions that promote safe and accessible living environments for older adults, thereby improving their quality of life.
本研究旨在确定与老年人在家中所经历的功能困难相关的人口统计学和住房特征。
年龄≥65岁且完成美国住房调查（AHS）问卷的个体。我们每户随机选择一人，并排除12项AHS功能挑战项目数据缺失的参与者。
比较多种机器学习模型以确定表现最佳的模型，然后用该模型分析人口统计学和住房特征对老年人在家中功能困难的影响。
随机森林模型因其较好的预测性能而被选中（准确率：85.8%，灵敏度：94.4%，特异度：60.2%，精确率：87.6%，阴性预测值：78.2%）。对该模型有显著影响的前五个变量为：1）行走障碍，2）使用拐杖或助行器，3）浴室中是否有或使用扶手或抓杆，4）离家外出障碍，5）自我照顾障碍。这些变量对模型的影响比户主的健康状况和年龄更大。
家庭改造和环境适应对于提高老年人的功能能力和独立性可能至关重要。这些发现可为开发促进老年人安全和无障碍生活环境的干预措施提供参考，从而改善他们的生活质量。
