NDLI: A web-based dynamic Nomogram for predicting instrumental activities of daily living disability in older adults: a nationally representative survey in China

Content Provider	Springer Nature : BioMed Central
Author	Zhang, Li Cui, Huijie Chen, Qiuzhi Li, Yan Yang, Chunxia Yang, Yanfang
Abstract	Background Instrumental Activities of Daily Living (IADL) disability is a common health burden in aging populations. The identification of high-risk individuals is essential for timely targeted interventions. Although predictors for IADL disability have been well described, studies constructing prediction tools for IADL disability among older adults were not adequately explored. Our study aims to develop and validate a web-based dynamic nomogram for individualized IADL disability prediction in older adults. Methods Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We included 4791 respondents aged 60 years and over, without IADL disability at baseline in the 2011 to 2013 cohort (training cohort) and 371 respondents in the 2013 to 2015 cohort (validation cohort). Here, we defined IADL disability as needing any help in any items of the Lawton and Brody’s scale. A web-based dynamic nomogram was built based on a logistic regression model in the training cohort. We validated the nomogram internally with 1000 bootstrap resamples and externally in the validation cohort. The discrimination and calibration ability of the nomogram was assessed using the concordance index (C-index) and calibration plots, respectively. Results The nomogram incorporated ten predictors, including age, education level, social activity frequency, drinking frequency, smoking frequency, comorbidity condition, self-report health condition, gait speed, cognitive function, and depressive symptoms. The C-index values in the training and validation cohort were 0.715 (bootstrap-corrected C-index = 0.702) and 0.737, respectively. The internal and external calibration plots for predictions of IADL disability were in excellent agreement. An online web server was built ( https://lilizhang.shinyapps.io/DynNomapp/ ) to facilitate the use of the nomogram. Conclusions We developed a dynamic nomogram to evaluate the risk of IADL disability precisely and expediently. The application of this nomogram would be helpful for health care physicians in decision-making.
Related Links	https://bmcgeriatr.biomedcentral.com/counter/pdf/10.1186/s12877-021-02223-9.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	14712318
DOI	10.1186/s12877-021-02223-9
Journal	BMC Geriatrics
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-05-17
Access Restriction	Open
Subject Keyword	Geriatrics Gerontology Aging Rehabilitation Instrumental activities of daily living disability Dynamic nomogram Prediction model Geriatrics/Gerontology
Content Type	Text
Resource Type	Article
Subject	Geriatrics and Gerontology
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	4.1/2023

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