Lifestyle Influence on Mild Cognitive Impairment Progression: A Decision Tree Prediction Model Study

Abstract

Jiwen Hou,1,2,* Hua Jiang,1,* Yan Han,1 Rong Huang,1 Xiang Gao,1 Wei Feng,1 Zongjun Guo2 1Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China; 2Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zongjun Guo, Department of Geriatrics, Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao, Shandong Province, People’s Republic of China, Tel [phone], Email [email protected]: This study assessed the influences of different lifestyle on mild cognitive impairment (MCI) progression and established a decision tree prediction model to analyse their predictive significance on MCI progression incidence.Patients and Methods: From October 2015 to February 2020,330 patients with MCI were recruited, and demographic and lifestyle information collected. They were followed up for 19.04 ± 10.227 months. Cognitive function was assessed using the Mini-Mental State Examination Scale every 6 months, and they were divided into MCI stable group and MCI progression group.Results: The Kaplan Meier survival analysis showed an overall cohort survival rate of 33.2%; the annual conversion rate of MCI progression was 20%. Physical exercise, social engagement, high-fat diet, age, napping, and tea drinking were decision tree prediction model nodes. Hobbies were the most important factor for predicting MCI progression. The MCI progression probability rates were: with hobbies 26.829% (44 cases), without hobbies 57.831% (96 cases); for those withot hobbies, with physical exercise 43.077% (28 cases) without physical exercise 72.340% (68 cases); for those without hobbies with physical exercise and social engagement 20.000% (4 cases), without social engagement 53.333% (24 cases); for those without hobbies, physical exercises and social engagement and with nap habits 48.485% (16 cases), without nap habits 66.667% (8 cases). The decision tree prediction model AUC for predicting the MCI progression receiver operating characteristic curve was 0.737 (95% confidence interval: 0.685– 0.785) (75.71% sensitivity, 71.75% specificity, P < 0.001.Conclusion: Hobbies, physical exercise, social engagement, napping, and drinking tea can help prevent MCI progression, while a high-fat diet may exacerbate MCI progression. In this study the rule with the lowest MCI progress probability for those who had hobbies, high-fat diet, and social engagement. And the decision tree model had good prediction efficiency.Keywords: lifestyle, mild cognitive impairment progression, survival analysis, decision tree prediction model

Keywords

• lifestyle
• mild cognitive impairment progression
• survival analysis
• decision tree prediction model