Method for screening healthy survival status markers of middle-aged and elderly people and application of method

Abstract

The invention relates to the field of medical health, in particular to a method for screening healthy survival status markers of middle-aged and elderly people and application thereof, and the method comprises the following steps: step 1, collecting and establishing a natural crowd queue, and respectively collecting basic information, laboratory inspection indexes and body mass indexes of the natural crowd queue; 2, directional monitoring is carried out by means of regular interview and the like; step 3, performing continuous follow-up visit on the natural crowd queue through a cause of death detection system, a chronic disease monitoring system and a hospital quality monitoring system to obtain the end of the natural crowd queue; and step 4, based on the outcome of the natural population queue, on the basis of the established CHARLS, evaluating and screening out markers with good prediction efficiency on the healthy survival state of the middle-aged and elderly people by various data in basic information, laboratory inspection indexes and body mass indexes. By adopting the technical scheme, the markers in different ways can be collected and analyzed, so that the markers mapping the healthy survival state of the old people can be screened.

Description

Technical Field

[0001] The present invention relates to the field of medical health, and in particular to a method for screening markers of healthy living status of middle-aged and elderly people and an application thereof. Background Art

[0002] With the development of economy and the progress of science and technology, people's life expectancy is constantly increasing while the fertility rate is constantly decreasing. Aging is gradually becoming a major problem faced by all countries. With the increase of age, the occurrence of major chronic diseases and the decline of physical functions have become one of the problems that the elderly must face. The occurrence of major chronic diseases and the decline of physical functions mean the gradual loss of healthy living status, which not only brings physical and mental pain to the elderly, but also causes serious economic burden to the family and society. It has become one of the major public health issues. Traditional risk factors, such as demographic characteristics (age, gender and education level, etc.), lifestyle (smoking and drinking, etc.) and previous medical history (hypertension, dyslipidemia, diabetes and atrial fibrillation, etc.) are important risk factors for adverse outcomes in middle-aged and elderly people. These risk factors are also an important basis for formulating disease prevention and control strategies for middle-aged and elderly people. However, the prevention and control strategies formulated for these traditional risk factors can only reduce the risk of adverse outcomes in middle-aged and elderly people to a limited extent. Therefore, exploring effective and reliable markers and conducting effective combined applications are of great significance to further reduce residual risks and prolong healthy living status.

[0003] With existing technologies, the combined application of multiple markers has been carried out in various specific disease areas, but their predictive value is still controversial. For example, a study that recruited 844 stroke patients found that further adding inflammatory markers to the prediction model containing IL-6 did not improve the prognostic value. The reason may be that the predictive ability of markers reflecting the same pathological mechanism is similar, and the accumulation of inflammatory markers does not provide additional predictive value. The comprehensive assessment of the healthy survival status of the human body involves different pathophysiological processes. Therefore, a method and application of screening markers of healthy survival status for middle-aged and elderly people covering multiple markers of different pathways is needed. Summary of the invention

[0004] To solve the above problems, the present invention provides a method for screening markers of healthy living status of middle-aged and elderly people and its application, which can screen markers that map the healthy living status of the elderly by collecting and analyzing markers covering different pathways.

[0005] In order to achieve the above object, the technical solution of the present invention is as follows: A method for screening markers of healthy living status of middle-aged and elderly people, comprising:

[0006] Step 1: Collect and establish a natural population cohort, and collect basic information, laboratory test indicators and body mass index of the natural population cohort. The laboratory test indicators include parameters representing glucose metabolism, lipid metabolism, renal function, inflammation, hemostasis, and oxygen transport mechanism. The body mass index includes waist-to-hip ratio, grip strength, gait speed, vital capacity and balance ability.

[0007] Step 2: targeted surveillance through a combination of regular face-to-face interviews and a health information platform for remote data collection;

[0008] Step 3: Continuously follow up the natural population cohort through the death cause detection system, chronic disease monitoring system and hospital quality monitoring system to obtain the outcomes of the natural population cohort;

[0009] Step 4: Based on the outcomes of natural population cohorts and on the basis of the established health and retirement tracking survey CHARLS, evaluate and screen out markers that have good predictive efficacy for the healthy survival status of middle-aged and elderly people in basic information, laboratory test indicators and body mass index data.

[0010] The above scheme has the following beneficial effects:

[0011] 1. In this scheme, the linkage effect of multiple markers is an independent predictor of the healthy survival status of middle-aged and elderly people. The risk prediction model constructed by combining multiple markers and traditional risk factors can substantially improve the predictive ability of the healthy survival status of middle-aged and elderly people.

[0012] 2. In this plan, based on the established China Health and Retirement Tracking Survey, routine laboratory examination indicators representing pathophysiological mechanisms such as glucose metabolism, lipid metabolism, renal function, inflammation, hemostasis, and oxygen transport, as well as physical examination indicators representing different physical conditions such as body mass index, waist-to-hip ratio, grip strength, and gait speed are evaluated to screen out markers with good predictive efficacy and construct a risk prediction model.

[0013] 3. In this plan, by expanding the information collected, the markers for judging the healthy survival status of the middle-aged and elderly people in the established health and pension tracking survey are expanded. This will increase the number of markers used to predict the healthy survival status of the middle-aged and elderly people, expand the independent predictive factors for judging the healthy survival status of the middle-aged and elderly people, reduce the number of markers acting on the same mechanism, and increase the entry points for judging the healthy survival status of the middle-aged and elderly people.

[0014] Furthermore, the basic information in step one includes age, gender, occupation and education level.

[0015] Beneficial effects: Age, gender, occupation and education level are all markers that may affect the survival status of middle-aged and elderly people. Age and gender can reflect the physical condition and structure of the subjects. Occupation can reflect the subjects' daily routine and labor intensity, and education level can reflect the subjects' cognitive level.

[0016] Furthermore, the basic information in step one also includes lifestyle and risk factors. Lifestyle includes work and physical activity, and risk factors include smoking and drinking.

[0017] Beneficial effects: Lifestyle can reflect the characteristics of the subjects' daily activities, thereby extracting factors that may affect their healthy survival from the subjects' normal activities. Risk factors can affect the health level of subjects through chronic effects, and therefore are also one of the factors that affect their healthy survival.

[0018] Furthermore, the basic information in step one also includes past medical history and past medication history.

[0019] Beneficial effects: Past medical history and past medication history will also affect the health status of the subject, so past medical history and past medication history are also within the screening scope of markers.

[0020] Furthermore, the laboratory examination indicators in step one include height, weight, waist circumference, blood pressure, blood sugar and blood lipids.

[0021] Beneficial effects: Laboratory examination indicators are indicators detected by laboratory instruments. Height, weight, waist circumference, blood pressure, blood sugar and blood lipids are all included in the laboratory examination indicators.

[0022] Furthermore, in step three, the triggering criteria for the outcome are new chronic disease or death.

[0023] Beneficial effect: When the subjects develop new chronic diseases or death as the outcome standard, the impact of each marker on the development of new chronic diseases or death can be understood through subsequent analysis.

[0024] Furthermore, in step 4, after the risk prediction model is established after the markers are evaluated, the surviving natural population cohort is marked as survivors, and the survivors' daily living activities ability scale, instrumental daily living activities scale, brief mental state examination scale and depression scale are recorded, and the functional outcomes of the survivors are evaluated based on the recorded results;

[0025] Functional outcomes included primary outcomes and secondary outcomes. The primary outcome was disability-free survival, and the secondary outcomes included major chronic disease-free survival, all-cause mortality, limitation in daily living activities, cognitive impairment, depression, and the development of major chronic diseases.

[0026] Beneficial effects: After the outcome is triggered, some subjects still survive and are marked as survivors. The survivors' daily living activities ability scale, instrumental daily living activities scale, brief mental state scale and depression scale are continued to be recorded to measure the impact of the markers and further evaluate the survivor outcomes. The survivor outcomes are divided into primary outcomes and secondary outcomes, which can further verify the impact of the markers on the survival status.

[0027] Furthermore, in step 4, multivariate logistic regression models or COX proportional hazard models were used to analyze the association and strength of association between each marker and the outcome, and the dose-response relationship between the marker and the risk of the study outcome;

[0028] The screened markers were divided into high-level exposure group and low-level exposure group according to the optimal cut-off point of the receiver operating characteristic curve, and the multivariate logistic regression model or COX proportional hazard model was used to analyze the relationship between the number of high-level markers and the outcomes.

[0029] Beneficial effects: The association and strength of association between markers and outcomes, as well as the dose-response relationship between markers and the risk of study outcomes, are analyzed through multivariate logistic regression models or COX proportional hazard models, so as to clarify the role and effect of the markers, as well as the mechanism of action.

[0030] An application for screening markers of healthy survival status of middle-aged and elderly people, characterized by being applied to screening markers in prediction models including life expectancy, healthy life expectancy and major chronic disease-free survival.

[0031] Markers can be applied to prediction models for life expectancy, healthy life expectancy and major chronic disease-free survival, and the relevant prediction results can be mapped through feedback from the marker action mechanism.

[0032] Additional aspects and advantages of the present invention will be given in part in the following description, and in part will be obvious from the following description, or will be learned through practice of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS

[0033] Figure 1 This is a schematic diagram of an embodiment of a method for screening markers of healthy living status for middle-aged and elderly people according to the present invention. DETAILED DESCRIPTION

[0034] The technical solution of the present invention will be described clearly and completely below in conjunction with the accompanying drawings. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0035] In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc., indicating the orientation or positional relationship, are based on the orientation or positional relationship shown in the drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as limiting the present invention. In addition, the terms "first", "second", and "third" are used for descriptive purposes only, and cannot be understood as indicating or implying relative importance.

[0036] In the description of the present invention, it should be noted that, unless otherwise clearly specified and limited, the terms "installed", "connected", and "connected" should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection, or it can be indirectly connected through an intermediate medium, or it can be the internal communication of two components. For ordinary technicians in this field, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0037] The following is further described in detail through specific implementation methods:

[0038] As attached Figure 1 As shown:

[0039] A method for screening markers of healthy living status of middle-aged and elderly people, comprising:

[0040] Step 1: Collect and establish a natural population cohort, and collect basic information, laboratory test indicators and body mass index of the natural population cohort. The laboratory test indicators include height, weight, waist circumference, blood pressure, blood sugar and blood lipids. The body mass index includes waist-to-hip ratio, grip strength, walking speed, vital capacity and balance ability. Basic information includes age, gender, occupation, education level, lifestyle, risk factors, previous medical history and previous medication history.

[0041] Step 2: targeted surveillance through a combination of regular face-to-face interviews and a health information platform for remote data collection;

[0042] Step 3: Continuously follow up the natural population cohort through the cause of death detection system, chronic disease monitoring system and hospital quality monitoring system to obtain the outcomes of the natural population cohort. The triggering criteria for the outcomes are new chronic diseases or death.

[0043] Step 4: Based on the outcomes of the natural population cohort and the established health and retirement tracking survey CHARLS, evaluate and screen out the markers with good predictive efficacy for the health and survival status of the middle-aged and elderly people in basic information, laboratory test indicators and body mass index data;

[0044] Multivariate logistic regression model or COX proportional hazard model was used to analyze the association and strength of association between each marker and outcome, and the dose-response relationship between the marker and the risk of the study outcome;

[0045] The screened markers were divided into high-level exposure group and low-level exposure group according to the optimal cut-off point of the receiver operating characteristic curve, and the relationship between the number of high-level markers and the outcome was analyzed using multivariate logistic regression model or COX proportional hazard model;

[0046] After the markers were evaluated and the risk prediction model was established, the surviving natural population cohort was marked as survivors, and the survivors' daily living activities ability scale, instrumental daily living activities scale, mini-mental state examination scale and depression scale were recorded, and the functional outcomes of the survivors were evaluated based on the recorded results;

[0047] Functional outcomes included primary outcomes and secondary outcomes. The primary outcome was disability-free survival, and the secondary outcomes included major chronic disease-free survival, all-cause mortality, limitation in daily living activities, cognitive impairment, depression, and the development of major chronic diseases.

[0048] The linkage effect of multiple markers is an independent predictor of the healthy survival status of middle-aged and elderly people. The risk prediction model constructed by combining multiple markers and traditional risk factors can substantially improve the predictive ability of the healthy survival status of middle-aged and elderly people.

[0049] Based on the established China Health and Retirement Longitudinal Study (CHARLS), the roles of markers such as height, weight, waist circumference, blood pressure, blood sugar, blood lipids, waist-to-hip ratio, grip strength, gait speed, vital capacity, balance ability, age, gender, occupation, education level, lifestyle, risk factors, previous medical history and previous medication history were evaluated, markers with good predictive efficacy were screened out, and a risk prediction model was constructed.

[0050] Among them, through the analysis of basic information, laboratory examination indicators and information in body mass index, it is possible to comprehensively analyze the living environment, personal experience and body capabilities of the subjects, so as to effectively and comprehensively screen out markers that can reflect a healthy living state.

[0051] Age, gender, occupation and education level are all markers that may affect the survival status of middle-aged and elderly people. Age and gender can reflect the physical condition and structure of the subjects. Occupation can reflect the subjects' daily routines and labor intensity, and education level can reflect the subjects' cognitive level. Lifestyle can map the characteristics of the subjects' daily activities, thereby extracting factors that may affect their healthy survival from the subjects' normal activities. Past medical history and past medication history will also affect the health status of the subjects, and can effectively determine related effects such as sequelae.

[0052] Through targeted monitoring combined with regular face-to-face interviews and a health information platform for remote data collection, it is possible to track subject information to ensure that the data of assessment markers can be updated, so that the status of the subjects can be effectively assessed before the outcome is obtained.

[0053] By continuously following up the natural population cohort through the cause of death detection system, chronic disease monitoring system and hospital quality monitoring system, we can use existing technology to collect and utilize the causes of death, chronic diseases and treatment experience factors of the subjects, thereby further broadening our understanding of the subjects and judging their outcomes.

[0054] By expanding the information collected, we can expand the markers for judging the healthy survival status of the middle-aged and elderly in the established health and pension tracking survey CHARLS. This will increase the number of markers used to predict the healthy survival status of the middle-aged and elderly, expand the independent predictive factors for judging the healthy survival status of the middle-aged and elderly, reduce the number of markers acting on the same mechanism, and increase the entry points for judging the healthy survival status of the middle-aged and elderly.

[0055] When the subjects develop new chronic diseases or die as the outcome criteria, subsequent analysis can be used to understand the impact of each marker on the new chronic disease or death. After the outcome is triggered, some subjects still survive and are marked as survivors. The survivors' daily living activities ability scale, instrumental daily living activities scale, simple mental state scale and depression scale are continued to be recorded to measure the impact of the markers and further evaluate the survivor outcomes. The survivor outcomes are divided into primary outcomes and secondary outcomes, which can further verify the impact of the markers on the survival status. The simple mental state scale also includes the patient's cognitive ability, which is assessed based on the subject's education level.

[0056] The association and strength of association between markers and outcomes, as well as the dose-response relationship between markers and the risk of study outcomes, are analyzed through multivariate logistic regression models or COX proportional hazard models, so as to clarify the role and effect of the markers, as well as the mechanism of action, and assist in the establishment of an effective prediction model.

[0057] An application for screening markers of healthy survival status of middle-aged and elderly people, characterized by being applied to screening markers in prediction models including life expectancy, healthy life expectancy and major chronic disease-free survival.

[0058] Markers can be applied to prediction models for life expectancy, healthy life expectancy and major chronic disease-free survival, and the relevant prediction results can be mapped through feedback from the marker action mechanism.

[0059] Obviously, the above embodiments are merely examples for the purpose of clear explanation, and are not intended to limit the implementation methods. For those skilled in the art, other different forms of changes or modifications can be made based on the above description. It is not necessary and impossible to list all the implementation methods here. The obvious changes or modifications derived therefrom are still within the scope of protection of the invention.

Claims

1. A method for screening markers of healthy living status of middle-aged and elderly people, characterized in that: include: Step 1: Collect and establish a natural population cohort, and collect basic information, laboratory test indicators and body mass index of the natural population cohort. The laboratory test indicators include parameters representing glucose metabolism, lipid metabolism, renal function, inflammation, hemostasis, and oxygen transport mechanism. The body mass index includes waist-to-hip ratio, grip strength, gait speed, vital capacity and balance ability. Step 2: targeted surveillance through a combination of regular face-to-face interviews and a health information platform for remote data collection; Step 3: Continuously follow up the natural population cohort through the death cause detection system, chronic disease monitoring system and hospital quality monitoring system to obtain the outcomes of the natural population cohort; Step 4: Based on the outcomes of natural population cohorts and on the basis of the established health and retirement tracking survey CHARLS, evaluate and screen out markers that have good predictive efficacy for the healthy survival status of middle-aged and elderly people in basic information, laboratory test indicators and body mass index data.

2. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 1, characterized in that: The basic information in step one includes age, gender, occupation and education level.

3. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 2, characterized in that: The basic information in step one also includes lifestyle and risk factors. Lifestyle includes work and physical activity, and risk factors include smoking and drinking.

4. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 3, characterized in that: The basic information in step one also includes past medical history and past medication history.

5. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 4, characterized in that: Laboratory examination indicators in step one include height, weight, waist circumference, blood pressure, blood sugar and blood lipids.

6. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 5, characterized in that: In step three, the triggering criteria for the outcome are new chronic disease or death.

7. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 6, characterized in that: In step 4, after the markers are evaluated and the risk prediction model is established, the surviving natural population cohort is marked as survivors, and the survivors' daily living activities ability scale, instrumental daily living activities scale, mini-mental state examination scale and depression scale are recorded, and the functional outcomes of the survivors are evaluated based on the recorded results; Functional outcomes included primary outcomes and secondary outcomes. The primary outcome was disability-free survival, and the secondary outcomes included major chronic disease-free survival, all-cause mortality, limitation in daily living activities, cognitive impairment, depression, and the development of major chronic diseases.

8. The method for screening markers of healthy living status of middle-aged and elderly people according to claim 7, characterized in that: In step 4, multivariate logistic regression model or COX proportional hazard model was used to analyze the association and strength of association between each marker and outcome, and the dose-response relationship between the marker and the risk of the study outcome; The screened markers were divided into high-level exposure group and low-level exposure group according to the optimal cut-off point of the receiver operating characteristic curve, and the multivariate logistic regression model or COX proportional hazard model was used to analyze the relationship between the number of high-level markers and the outcomes.

9. An application for screening markers of healthy living status of middle-aged and elderly people, based on the application of the method for screening markers of healthy living status of middle-aged and elderly people according to claim 8, characterized in that: Applied to marker screening in prediction models including life expectancy, healthy life expectancy and major chronic disease-free survival.

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