Wang Zhe, Jia Ni
Department of Public Health, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
PLoS One. 2025 Mar 18;20(3):e0319232. doi: 10.1371/journal.pone.0319232. eCollection 2025.
To develop a predictive model for evaluating depression among middle-aged and elderly individuals in China.
Participants aged ≥ 45 from the 2020 China Health and Retirement Survey (CHARLS) cross-sectional study were enrolled. Depressive mood was defined as a score of 10 or higher on the CESD-10 scale, which has a maximum score of 30. A predictive model was developed using five selected machine learning algorithms. The model was trained and validated on the 2020 database cohort and externally validated through a questionnaire survey of middle-aged and elderly individuals in Shaanxi Province, China, following the same criteria. SHapley Additive Interpretation (SHAP) was employed to assess the importance of predictive factors.
The stacked ensemble model demonstrated an AUC of 0.8021 in the test set of the training cohort for predicting depressive symptoms; the corresponding AUC in the external validation cohort was 0.7448, outperforming all base models.
The stacked ensemble approach serves as an effective tool for identifying depression in a large population of middle-aged and elderly individuals in China. For depression prediction, factors such as life satisfaction, self-reported health, pain, sleep duration, and cognitive function are identified as highly significant predictive factors.
建立一个用于评估中国中老年人群抑郁症的预测模型。
纳入2020年中国健康与养老追踪调查(CHARLS)横断面研究中年龄≥45岁的参与者。抑郁情绪定义为在CESD-10量表上得分10分及以上,该量表满分30分。使用五种选定的机器学习算法建立预测模型。该模型在2020年数据库队列上进行训练和验证,并按照相同标准通过对中国陕西省中老年人群的问卷调查进行外部验证。采用夏普利值附加解释(SHAP)来评估预测因素的重要性。
在训练队列的测试集中,堆叠集成模型预测抑郁症状的AUC为0.8021;在外部验证队列中的相应AUC为0.7448,优于所有基础模型。
堆叠集成方法是识别中国大量中老年人群抑郁症的有效工具。对于抑郁症预测,生活满意度、自我报告的健康状况、疼痛、睡眠时间和认知功能等因素被确定为高度显著的预测因素。