Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults

Abstract Multimorbidity has emerged as a significant public health issue in the context of global population aging. Predicting and managing the progression of multimorbidity in the elderly population is crucial. This study aims to develop predictive models for multimorbidity trajectories in middle-a...

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Main Authors: Li Yao, Qiaoxing Li, Zihan Zhou, Jiajia Yin, Tingrui Wang, Yan Liu, Qinqin Li, Lu Xiao, Dongliang Yang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-07060-z
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author Li Yao
Qiaoxing Li
Zihan Zhou
Jiajia Yin
Tingrui Wang
Yan Liu
Qinqin Li
Lu Xiao
Dongliang Yang
author_facet Li Yao
Qiaoxing Li
Zihan Zhou
Jiajia Yin
Tingrui Wang
Yan Liu
Qinqin Li
Lu Xiao
Dongliang Yang
author_sort Li Yao
collection DOAJ
description Abstract Multimorbidity has emerged as a significant public health issue in the context of global population aging. Predicting and managing the progression of multimorbidity in the elderly population is crucial. This study aims to develop predictive models for multimorbidity trajectories in middle-aged and elderly populations and to identify the key factors influencing the progression of multimorbidity. First, a time-series clustering method was used to construct the multimorbidity trajectories. Then, predictive models based on machine learning techniques were developed to forecast the progression of different trajectories and identify key risk factors. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) database, including 12,198 middle-aged and elderly individuals (aged 45 and above). Four distinct multimorbidity progression patterns were identified: Stable Low-Risk Group (45.26%), Progressively Worsening Group (14.35%), Moderate Stability Group (31.90%) and Consistently Deteriorating Group (8.49%). Among the predictive models, the XGBoost model achieved the best performance, with an accuracy of 0.664 (95%CI: 0.648-0.681), a macro ROC–AUC of 0.825 (95%CI: 0.816-0.834), a micro ROC–AUC of 0.884 (95%CI: 0.876-0.892), and a log loss of 0.806 (95%CI: 0.781-0.831). Other models, including Random Forest, Support Vector Machine, Logistic Regression, and Artificial Neural Networks, showed similar accuracy and ROC–AUC values. The study identified three key factors—baseline disease counts, self-rated Activities of Daily Living (ADL), and self-rated health status—as critical predictors of multimorbidity trajectories.
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spelling doaj-art-e01e2397306c4144bfeb3fa5d008de592025-08-20T03:05:22ZengNature PortfolioScientific Reports2045-23222025-07-0115111410.1038/s41598-025-07060-zMachine learning models for predicting multimorbidity trajectories in middle-aged and elderly adultsLi Yao0Qiaoxing Li1Zihan Zhou2Jiajia Yin3Tingrui Wang4Yan Liu5Qinqin Li6Lu Xiao7Dongliang Yang8School of Management and Collaborative Innovation Laboratory of Digital Transformation and Governance, Guizhou UniversitySchool of Management and Collaborative Innovation Laboratory of Digital Transformation and Governance, Guizhou UniversitySchool of Nursing, Guizhou Medical UniversitySchool of Nursing, Guizhou Medical UniversitySchool of Nursing, Guizhou Medical UniversitySchool of Nursing, Guizhou Medical UniversitySchool of Nursing, Guizhou Medical UniversitySchool of Tourism Management, Guizhou University of CommerceCangzhou Medical CollegeAbstract Multimorbidity has emerged as a significant public health issue in the context of global population aging. Predicting and managing the progression of multimorbidity in the elderly population is crucial. This study aims to develop predictive models for multimorbidity trajectories in middle-aged and elderly populations and to identify the key factors influencing the progression of multimorbidity. First, a time-series clustering method was used to construct the multimorbidity trajectories. Then, predictive models based on machine learning techniques were developed to forecast the progression of different trajectories and identify key risk factors. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) database, including 12,198 middle-aged and elderly individuals (aged 45 and above). Four distinct multimorbidity progression patterns were identified: Stable Low-Risk Group (45.26%), Progressively Worsening Group (14.35%), Moderate Stability Group (31.90%) and Consistently Deteriorating Group (8.49%). Among the predictive models, the XGBoost model achieved the best performance, with an accuracy of 0.664 (95%CI: 0.648-0.681), a macro ROC–AUC of 0.825 (95%CI: 0.816-0.834), a micro ROC–AUC of 0.884 (95%CI: 0.876-0.892), and a log loss of 0.806 (95%CI: 0.781-0.831). Other models, including Random Forest, Support Vector Machine, Logistic Regression, and Artificial Neural Networks, showed similar accuracy and ROC–AUC values. The study identified three key factors—baseline disease counts, self-rated Activities of Daily Living (ADL), and self-rated health status—as critical predictors of multimorbidity trajectories.https://doi.org/10.1038/s41598-025-07060-zMultimorbidityTrajectoryPrediction model
spellingShingle Li Yao
Qiaoxing Li
Zihan Zhou
Jiajia Yin
Tingrui Wang
Yan Liu
Qinqin Li
Lu Xiao
Dongliang Yang
Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults
Scientific Reports
Multimorbidity
Trajectory
Prediction model
title Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults
title_full Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults
title_fullStr Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults
title_full_unstemmed Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults
title_short Machine learning models for predicting multimorbidity trajectories in middle-aged and elderly adults
title_sort machine learning models for predicting multimorbidity trajectories in middle aged and elderly adults
topic Multimorbidity
Trajectory
Prediction model
url https://doi.org/10.1038/s41598-025-07060-z
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