Huifen Hu

Using two prospective cohorts, the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018, n=3,622) and the English Longitudinal Study of Ageing (ELSA, 2012–2020, n=2,059), this study followed middle-aged and older adults with LAP-defined MASLD and no baseline frailty, selected 14 consensus predictors from 31 candidates via LASSO, Boruta, and recursive feature elimination, and trained nine machine learning models; logistic regression performed best (internal test AUC 0.740; external validation AUC 0.753), pain was the top predictor (mean absolute SHAP 0.184), pain remained associated with incident frailty after full adjustment including baseline frailty index (CHARLS RR 1.219; ELSA RR 1.310) with PAFs of 8.01% and 11.

Using two prospective cohorts, the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018, n=3,622) and the English Longitudinal Study of Ageing (ELSA, 2012–2020, n=2,059), this study followed middle-aged and older adults with LAP-defined MASLD and no baseline frailty, selected 14 consensus predictors from 31 candidates via LASSO, Boruta, and recursive feature elimination, and trained nine machine learning models; logistic regression performed best (internal test AUC 0.740; external validation AUC 0.753), pain was the top predictor (mean absolute SHAP 0.184), pain remained associated with incident frailty after full adjustment including baseline frailty index (CHARLS RR 1.219; ELSA RR 1.310) with PAFs of 8.01% and 11.