Zhang Bao-Xuan, Luo Jin-Ping, Sun Jia-Ying, Geng Ming-Hui, Mou Yi-Fan, Cheng Nan-Nan, Wang Zhao-Xuan, Yin Wen-Qiang, Chen Zhong-Ming, Ma Dong-Ping
School of Management, Shandong Second Medical University, Shandong, China.
"Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China.
Front Public Health. 2025 Jun 3;13:1531872. doi: 10.3389/fpubh.2025.1531872. eCollection 2025.
Arthritis is the most disabling disease worldwide, and the presence of the disease usually greatly threatens the patient's activities of daily living (ADL). Currently, there are a few studies that are related to exploring factors associated with impaired ADL in middle-aged and older adult arthritis patients. This study aimed to explore the factors associated with impaired ADL in Chinese middle-aged and older adult patients through logistic regression and decision tree models.
The method of univariate analysis was the chi-square test. Variables with significant differences in univariate analysis were included in binary logistic regression model and decision tree model based on the E-CHAID algorithm to explore the factors associated with impaired ADL in middle-aged and older adult arthritis patients in China.
The results of the logistic regression model indicated that sex, place of residence, age, education level, falls, Internet usage, depressive symptoms, pain, self-rated health, and number of comorbid chronic diseases were the influencing factors for impaired ADL. The decision tree results showed that pain was the most important variable predicting impaired ADL in middle-aged and older adult arthritis patients. The area under the curve of the logistic regression model and the decision tree model were 0.792 (95%CI: 0.780-0.804) and 0.767 (95%CI: 0.754-0.780), respectively.
The results of the study suggest that pain, self-rated health, Internet usage, age, and depressive symptoms are significant correlates of impaired ADL. Primary care providers need to provide intervention strategies that are individualized to the middle-aged and older adults with arthritis themselves.
关节炎是全球最具致残性的疾病,该疾病的存在通常会极大地威胁患者的日常生活活动(ADL)。目前,有一些研究与探索中老年关节炎患者ADL受损相关因素有关。本研究旨在通过逻辑回归和决策树模型探索中国中老年患者ADL受损的相关因素。
单因素分析方法为卡方检验。单因素分析中有显著差异的变量纳入基于E-CHAID算法的二元逻辑回归模型和决策树模型,以探索中国中老年关节炎患者ADL受损的相关因素。
逻辑回归模型结果表明,性别、居住地点、年龄、教育水平、跌倒、互联网使用、抑郁症状、疼痛、自评健康状况和慢性合并症数量是ADL受损的影响因素。决策树结果显示,疼痛是预测中老年关节炎患者ADL受损的最重要变量。逻辑回归模型和决策树模型的曲线下面积分别为0.792(95%CI:0.780-0.804)和0.767(95%CI:0.754-0.780)。
研究结果表明,疼痛、自评健康状况、互联网使用、年龄和抑郁症状是ADL受损的显著相关因素。初级保健提供者需要为患有关节炎的中老年患者提供个性化的干预策略。