Can Loneliness be Predicted? Development of a Risk Prediction Model for Loneliness among Elderly Chinese: A Study Based on CLHLS.

Background: Loneliness is prevalent among the elderly, worsened by global aging trends. It impacts mental and physiological health. Traditional scales for measuring loneliness may be biased due to cognitive decline and varying definitions. Machine learning advancements offer potential improvements in risk prediction models. Methods: Data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), involving over 16,000 participants aged ≥65 years, were used. The study examined the relationships between loneliness and factors such as cognitive function, functional limitations, living conditions, environmental influences, age-related health issues, and health behaviors. Using R 4.4.1, seven predictive models were developed: logistic regression, ridge regression, support vector machines, K-nearest neighbors, decision trees, random forests, and multi-layer perceptron. Models were evaluated based on ROC curves, accuracy, precision, recall, F1 scores, and AUC. Results: Loneliness prevalence among elderly Chinese was 23.4%. Analysis identified 16 predictive factors and evaluated seven models. Logistic regression was the most effective model for predicting loneliness risk due to its economic and operational advantages. Conclusion: The study found a 23.4% prevalence of loneliness among elderly individuals in China. SHAP values indicated that higher MMSE scores correlate with lower loneliness levels. Logistic regression was the superior model for predicting loneliness risk in this population.