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Research Article: Prediction of depressive symptoms in middle-aged and older adult hospitalized patients with chronic diseases: a multicenter study in Anhui, China using machine learning methods

Date Published: 2026-07-09

Abstract:
This cross-sectional study has dual objectives: to investigate the predictive value of machine learning (ML) for the prevalence of depressive symptoms in middle-aged and older adult hospitalized patients with chronic diseases, and to identify significant factors influencing depressive symptoms in this population. A cross-sectional study was conducted among 618 hospitalized middle-aged and older adult patients with chronic diseases. Participants completed questionnaires assessing depression, chronic illness stigma, oral frailty, social isolation, family health, and demographic characteristics. The XG Boost model algorithm was employed for feature selection and variable importance ranking. A predictive model was constructed to assess the risk of depressive symptoms, and the feature importance honeycomb plot was utilized to illustrate the relationships between variables and prediction outcomes. The study found multiple risk factors significantly associated with depression, including gender, place of residence, number of surgeries in the past year, hospitalization in the past 2?years, social isolation, level of education, comorbidity, age, malignant disease, oral frailty, stigma associated with illness, and family health. The XG Boost model demonstrated optimal predictive performance, achieving an AUC value of 0.931. Key predictive factors included stigma scale for chronic, family health, oral frailty, social isolation, malignant disease, and hospitalization in the past 2?years. This study constructed a risk prediction model for depressive symptoms in middle-aged and older adult hospitalized patients with chronic diseases, providing an important reference basis for mental health interventions in this population.

Introduction:
According to China’s seventh national population census, there are currently 264 million people aged 60 and above in China, accounting for 18.7% of the total population ( 1 ). According to the “National Assessment Report on Aging and Health in China” released by the World Health Organization (WHO), it is projected that by 2030, the prevalence of chronic non-communicable diseases among the older adults in China will increase by at least 40%, with over 75% of the older adult population facing multimorbidity issues (…

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