Development and validation of a predictive nomogram for frailty based on thyroid function in older adults.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

European Geriatric Medicine Pub Date : 2025-06-17 DOI:10.1007/s41999-025-01247-3

Xiaotian Shi, Huayu Yang, Shan Wang, Yifan Yang, Yuanyuan Li, Guoze Dou, Qing Ma

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引用次数: 0

Abstract

Introduction: This study aimed to develop and validate a frailty prediction model incorporating thyroid hormone levels in older adults with normal thyroid function.

Methods: A total of 767 participants aged ≥ 65 years (566 males, 73.8%) were enrolled between December 2019 and December 2023. Participants were randomly assigned to training (n = 546) and internal validation (n = 235) sets; an external validation cohort was recruited between December 2023 and December 2024. Frailty was assessed using the FRAIL scale. Predictors were selected through LASSO and logistic regression analyses, and a nomogram was constructed for clinical application.

Results: A total of 767 patients were included, with a median age of 81 years. Of these, 205 individuals (26.7%) were classified into the frailty group. The restricted cubic spline plot showed a negative correlation between the FT3/FT4 and frailty after adjusting for multiple confounding factors. Five predictors, age, polypharmacy, MNA.SF score, grip, and FT3/FT4 were incorporated to establish the model. The model performed well achieving AUC values of 0.92 and 0.80 in the development and external validation datasets, respectively. The Calibration curves and DCA results suggested that the model possesses satisfactory predictive performance.

Conclusions: We developed a clinically applicable model to predict frailty in older adults with normal thyroid function, highlighting the relevance of thyroid hormone status in frailty risk assessment.

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基于老年人甲状腺功能的衰弱预测图的开发和验证。

本研究旨在建立并验证一个结合甲状腺功能正常的老年人甲状腺激素水平的衰弱预测模型。方法：在2019年12月至2023年12月期间，共有767名年龄≥65岁的参与者（566名男性，73.8%）入组。参与者被随机分配到训练组（n = 546）和内部验证组（n = 235）；在2023年12月至2024年12月期间招募了一个外部验证队列。使用虚弱量表评估虚弱程度。通过LASSO和logistic回归分析选择预测因子，并构建拟合图供临床应用。结果：共纳入767例患者，中位年龄81岁。其中，205人（26.7%）被归为虚弱组。限制三次样条图显示，调整多种混杂因素后，FT3/FT4与脆性呈负相关。五个预测因素，年龄，多种药物，MNA。结合SF评分、握感、FT3/FT4建立模型。该模型在开发和外部验证数据集中的AUC值分别为0.92和0.80，表现良好。校正曲线和DCA结果表明，该模型具有满意的预测性能。结论：我们建立了一个临床适用的模型来预测甲状腺功能正常的老年人的衰弱，强调了甲状腺激素状态在衰弱风险评估中的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.