Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach

BackgroundAs the global population ages, the economic burden of dementia continues to rise. Social isolation—which includes limited social interaction and feelings of loneliness—negatively affects cognitive function and is a significant risk factor for dementia. Individuals w...

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Main Authors: Bada Kang, Min Kyung Park, Jennifer Ivy Kim, Seolah Yoon, Seok-Jae Heo, Chaeeun Kang, SungHee Lee, Yeonkyu Choi, Dahye Hong
Format: Article
Language:English
Published: JMIR Publications 2025-06-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e69379
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author Bada Kang
Min Kyung Park
Jennifer Ivy Kim
Seolah Yoon
Seok-Jae Heo
Chaeeun Kang
SungHee Lee
Yeonkyu Choi
Dahye Hong
author_facet Bada Kang
Min Kyung Park
Jennifer Ivy Kim
Seolah Yoon
Seok-Jae Heo
Chaeeun Kang
SungHee Lee
Yeonkyu Choi
Dahye Hong
author_sort Bada Kang
collection DOAJ
description BackgroundAs the global population ages, the economic burden of dementia continues to rise. Social isolation—which includes limited social interaction and feelings of loneliness—negatively affects cognitive function and is a significant risk factor for dementia. Individuals with subjective cognitive decline and mild cognitive impairment represent predementia stages in which functional decline may still be reversible. Therefore, identifying factors related to social isolation in these at-risk groups is crucial, as early detection and intervention can help mitigate the risk of further cognitive decline. ObjectiveThis study aims to develop and validate machine learning models to identify and explore factors related to social interaction frequency and loneliness levels among older adults in the predementia stage. MethodsThe study included 99 community-dwelling older adults aged 65 years and above in the predementia stage. Social interaction frequency and loneliness levels were assessed 4 times daily using mobile ecological momentary assessment over a 2-week period. Actigraphy data were categorized into 4 domains: sleep quantity, sleep quality, physical movement, and sedentary behavior. Demographic and health-related survey data collected at baseline were also included in the analysis. Machine learning models, including logistic regression, random forest, Gradient Boosting Machine, and Extreme Gradient Boosting, were used to explore factors associated with low social interaction frequency and high levels of loneliness. ResultsOf the 99 participants, 43 were classified into the low social interaction frequency group, and 37 were classified into the high loneliness level group. The random forest model was the most suitable for exploring factors associated with low social interaction frequency (accuracy 0.849; precision 0.837; specificity 0.857; and area under the receiver operating characteristic curve 0.935). The Gradient Boosting Machine model performed best for identifying factors related to high loneliness levels (accuracy 0.838; precision 0.871; specificity 0.784; and area under the receiver operating characteristic curve 0.887). ConclusionsThis study demonstrated the potential of machine learning–based exploratory models, using data collected from mobile ecological momentary assessment and wearable actigraphy, to detect vulnerable groups in terms of social interaction frequency and loneliness levels among older adults with subjective cognitive decline and mild cognitive impairment. Our findings highlight physical movement as a key factor associated with low social interaction frequency, and sleep quality as a key factor related to loneliness. These results suggest that social interaction frequency and loneliness may operate through distinct mechanisms. Ultimately, this approach may contribute to preventing cognitive and physical decline in older adults at high risk of dementia. International Registered Report Identifier (IRRID)RR2-10.1177/20552076241269555
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spelling doaj-art-d80deb16d4344a8a9f3f858182bf999f2025-08-20T03:23:15ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-06-0127e6937910.2196/69379Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning ApproachBada Kanghttps://orcid.org/0000-0002-7002-2315Min Kyung Parkhttps://orcid.org/0000-0002-2568-8855Jennifer Ivy Kimhttps://orcid.org/0000-0003-1845-2200Seolah Yoonhttps://orcid.org/0009-0007-9048-0077Seok-Jae Heohttps://orcid.org/0000-0002-8764-7995Chaeeun Kanghttps://orcid.org/0009-0007-4504-0953SungHee Leehttps://orcid.org/0000-0002-4360-1565Yeonkyu Choihttps://orcid.org/0009-0008-2628-3738Dahye Honghttps://orcid.org/0009-0002-6054-773X BackgroundAs the global population ages, the economic burden of dementia continues to rise. Social isolation—which includes limited social interaction and feelings of loneliness—negatively affects cognitive function and is a significant risk factor for dementia. Individuals with subjective cognitive decline and mild cognitive impairment represent predementia stages in which functional decline may still be reversible. Therefore, identifying factors related to social isolation in these at-risk groups is crucial, as early detection and intervention can help mitigate the risk of further cognitive decline. ObjectiveThis study aims to develop and validate machine learning models to identify and explore factors related to social interaction frequency and loneliness levels among older adults in the predementia stage. MethodsThe study included 99 community-dwelling older adults aged 65 years and above in the predementia stage. Social interaction frequency and loneliness levels were assessed 4 times daily using mobile ecological momentary assessment over a 2-week period. Actigraphy data were categorized into 4 domains: sleep quantity, sleep quality, physical movement, and sedentary behavior. Demographic and health-related survey data collected at baseline were also included in the analysis. Machine learning models, including logistic regression, random forest, Gradient Boosting Machine, and Extreme Gradient Boosting, were used to explore factors associated with low social interaction frequency and high levels of loneliness. ResultsOf the 99 participants, 43 were classified into the low social interaction frequency group, and 37 were classified into the high loneliness level group. The random forest model was the most suitable for exploring factors associated with low social interaction frequency (accuracy 0.849; precision 0.837; specificity 0.857; and area under the receiver operating characteristic curve 0.935). The Gradient Boosting Machine model performed best for identifying factors related to high loneliness levels (accuracy 0.838; precision 0.871; specificity 0.784; and area under the receiver operating characteristic curve 0.887). ConclusionsThis study demonstrated the potential of machine learning–based exploratory models, using data collected from mobile ecological momentary assessment and wearable actigraphy, to detect vulnerable groups in terms of social interaction frequency and loneliness levels among older adults with subjective cognitive decline and mild cognitive impairment. Our findings highlight physical movement as a key factor associated with low social interaction frequency, and sleep quality as a key factor related to loneliness. These results suggest that social interaction frequency and loneliness may operate through distinct mechanisms. Ultimately, this approach may contribute to preventing cognitive and physical decline in older adults at high risk of dementia. International Registered Report Identifier (IRRID)RR2-10.1177/20552076241269555https://www.jmir.org/2025/1/e69379
spellingShingle Bada Kang
Min Kyung Park
Jennifer Ivy Kim
Seolah Yoon
Seok-Jae Heo
Chaeeun Kang
SungHee Lee
Yeonkyu Choi
Dahye Hong
Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach
Journal of Medical Internet Research
title Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach
title_full Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach
title_fullStr Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach
title_full_unstemmed Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach
title_short Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach
title_sort exploring factors related to social isolation among older adults in the predementia stage using ecological momentary assessments and actigraphy machine learning approach
url https://www.jmir.org/2025/1/e69379
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