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<p>Chronic respiratory diseases represent a leading cause of global mortality, yet robust prediction tools integrating onset risk and long-term prognosis for aging populations remain scarce. Here, we present a dual-stage predictive framework for self-reported physician-diagnosed chronic lung disease, asthma, and lung cancer using two nationally representative Chinese cohorts. By systematically evaluating 96 fully linear models, we identified distinct pathophysiological drivers for disease onset versus mortality. While disease susceptibility was primarily driven by non-pulmonary comorbidities and systemic inflammation, survival outcomes were predominantly determined by functional exhaustion and frailty indicators. The two models achieved decent external validation in an oldest-old cohort. These findings elucidate a critical shift from disease accumulation to functional decline in respiratory pathology, providing an interpretable, evidence-based tool for early risk stratification and precise clinical intervention in elderly patients.</p>

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Development and external validation of a dual-stage predictive model for self-reported physician-diagnosed chronic lung disease, asthma, and lung cancer in Chinese adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月4日

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  • Xuefen Cui,
  • Xueying Sun

摘要

Chronic respiratory diseases represent a leading cause of global mortality, yet robust prediction tools integrating onset risk and long-term prognosis for aging populations remain scarce. Here, we present a dual-stage predictive framework for self-reported physician-diagnosed chronic lung disease, asthma, and lung cancer using two nationally representative Chinese cohorts. By systematically evaluating 96 fully linear models, we identified distinct pathophysiological drivers for disease onset versus mortality. While disease susceptibility was primarily driven by non-pulmonary comorbidities and systemic inflammation, survival outcomes were predominantly determined by functional exhaustion and frailty indicators. The two models achieved decent external validation in an oldest-old cohort. These findings elucidate a critical shift from disease accumulation to functional decline in respiratory pathology, providing an interpretable, evidence-based tool for early risk stratification and precise clinical intervention in elderly patients.