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Obesity as a risk factor for developing functional limitation among older adults: A conditional inference tree analysis
Author(s) -
Cheng Feon W.,
Gao Xiang,
Bao Le,
Mitchell Diane C.,
Wood Craig,
Sliwinski Martin J.,
SmiciklasWright Helen,
Still Christopher D.,
Rolston David D. K.,
Jensen Gordon L.
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21861
Subject(s) - odds ratio , multivariate statistics , logistic regression , medicine , confidence interval , inference , odds , multivariate analysis , comorbidity , demography , gerontology , statistics , computer science , mathematics , artificial intelligence , sociology
Objective To examine the risk factors of developing functional decline and make probabilistic predictions by using a tree‐based method that allows higher order polynomials and interactions of the risk factors. Methods The conditional inference tree analysis, a data mining approach, was used to construct a risk stratification algorithm for developing functional limitation based on BMI and other potential risk factors for disability in 1,951 older adults without functional limitations at baseline (baseline age 73.1 ± 4.2 y). We also analyzed the data with multivariate stepwise logistic regression and compared the two approaches (e.g., cross‐validation). Over a mean of 9.2 ± 1.7 years of follow‐up, 221 individuals developed functional limitation. Results Higher BMI, age, and comorbidity were consistently identified as significant risk factors for functional decline using both methods. Based on these factors, individuals were stratified into four risk groups via the conditional inference tree analysis. Compared to the low‐risk group, all other groups had a significantly higher risk of developing functional limitation. The odds ratio comparing two extreme categories was 9.09 (95% confidence interval: 4.68, 17.6). Conclusions Higher BMI, age, and comorbid disease were consistently identified as significant risk factors for functional decline among older individuals across all approaches and analyses.