AI Machine Learning–Based Diabetes Prediction in Older Adults in South Korea: Cross-Sectional Analysis
Bibliographic record
Abstract
Background: Diabetes is prevalent in older adults, and machine learning algorithms could help predict diabetes in this population. Objective: This study determined diabetes risk factors among older adults aged ≥60 years using machine learning algorithms and selected an optimized prediction model. Methods: This cross-sectional study was conducted on 3084 older adults aged ≥60 years in Seoul from January to November 2023. Data were collected using a mobile app (Gosufit) that measured depression, stress, anxiety, basal metabolic rate, oxygen saturation, heart rate, and average daily step count. Health coordinators recorded data on diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, percent body fat, and percent muscle. The presence of diabetes was the target variable, with various health indicators as predictors. Machine learning algorithms, including random forest, gradient boosting model, light gradient boosting model, extreme gradient boosting model, and k-nearest neighbors, were employed for analysis. The dataset was split into 70% training and 30% testing sets. Model performance was evaluated using accuracy, precision, recall, F1 score, and area under the curve (AUC). Shapley additive explanations (SHAPs) were used for model interpretability. Results: Significant predictors of diabetes included hypertension (χ²1=197.294; P<.001), hyperlipidemia (χ²1=47.671; P<.001), age (mean: diabetes group 72.66 years vs nondiabetes group 71.81 years), stress (mean: diabetes group 42.68 vs nondiabetes group 41.47; t3082=-2.858; P=.004), and heart rate (mean: diabetes group 75.05 beats/min vs nondiabetes group 73.14 beats/min; t3082=-7.948; P<.001). The extreme gradient boosting model (XGBM) demonstrated the best performance, with an accuracy of 84.88%, precision of 77.92%, recall of 66.91%, F1 score of 72.00, and AUC of 0.7957. The SHAP analysis of the top-performing XGBM revealed key predictors for diabetes: hypertension, age, percent body fat, heart rate, hyperlipidemia, basal metabolic rate, stress, and oxygen saturation. Hypertension strongly increased diabetes risk, while advanced age and elevated stress levels also showed significant associations. Hyperlipidemia and higher heart rates further heightened diabetes probability. These results highlight the importance and directional impact of specific features in predicting diabetes, providing valuable insights for risk stratification and targeted interventions. Conclusions: This study focused on modifiable risk factors, providing crucial data for establishing a system for the automated collection of health information and lifelog data from older adults using digital devices at service facilities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".