Use of machine learning approach to predict depression in the elderly in China: A longitudinal study

Early detection of potential depression among elderly people is conducive for timely preventive intervention and clinical care to improve quality of life. Therefore, depression prediction considering sequential progression patterns in elderly needs to be further explored. We selected 1,538 elderly people from Chinese Longitudinal Healthy Longevity Study (CLHLS) wave 3–7 survey. Long short-term memory (LSTM) and six machine learning (ML) models were used to predict different depression risk factors and the depression risks in the elderly population in the next two years. Receiver operating curve (ROC) and decision curve analysis (DCA) were used to evaluate the prediction accuracy of the reference model and ML models. The area under the ROC curve (AUC) values of logistic regression with lasso regularisation (AUC=0.629, p-value=0.020) was the highest among ML models. DCA results showed that the net benefit of six ML models was similar (threshold: 0.00-0.10), the net benefit of lasso regression was the largest (threshold: 0.10-0.17 and 0.22-0.25), and the net benefit of DNN was the largest (threshold: 0.17–0.22 and 0.25–0.40). In two ML models, activities of daily living (ADL)/ instrumental ADL (IADL), self-rated health, marital status, arthritis, and number of cohabiting were the most important predictors for elderly with depression. The retrospective waves used in the LSTM model need to be further increased. The decision support system based on the proposed LSTM+ML model may be very valuable for doctors, nurses and community medical providers for early diagnosis and intervention.