Social determinants of the association among cerebrovascular disease, hearing loss and cognitive impairment in a middle-aged or older population: Recurrent neural network analysis of the Korean Longitudinal Study of Aging (2014–2016)

Aim: The present study used a deep learning model (recurrent neural network) for testing: (i) whether social determinants are major determinants of the association among cerebrovascular disease, hearing loss and cognitive impairment in a middle-aged or older population (hypothesis 1); and (ii) whether the association among the three diseases is very strong in the middle-aged or older population (hypothesis 2). Methods: Data came from the Korean Longitudinal Study of Aging (2014–2016), with 6060 participants aged ≥53 years. The association among the three diseases was divided into eight categories: one category for having no disease, three categories for having one disease, three categories for having two diseases and one category for having three diseases. Variable importance, the effect of a variable on model performance, was used for evaluating the two hypotheses. Hypothesis 1 was based on whether family support, socioeconomic status and social activity in the year 2014 were the top 10 determinants of the association in the year 2016. Hypothesis 2 was based on whether cerebrovascular disease, hearing loss and cognitive impairment in the year 2014 were the top five determinants of the association in the year 2016. Results: Based on variable importance from the recurrent neural network, cerebrovascular disease (0.0386), cognitive impairment (0.0151) and hearing loss (0.0092) in 2014 were the top three determinants of the association in 2016. Children alive (0.0072), education (0.0049), income (0.0075), friendship activity (0.0042) and marriage (0.0036) in 2014 were the top 10 determinants of the association in 2016. Conclusions: The findings of the present study support the two hypotheses, highlighting the importance of preventive measures, family support, socioeconomic status and friendship activity for managing the three diseases. Geriatr Gerontol Int 2019; 19: 711–716.