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Yu-Kun Zhang,1 Xian Shao,2 Su-Tao Hu,1 Tianshu Gu,1 Xing Liu,1 Tong Liu,1 Kang-Yin Chen1 1Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin, 300211, People’s Republic of China; 2Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of ChinaCorrespondence: Kang-Yin Chen, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, People’s Republic of China, Email chenkangyin@vip.126.comPurpose: Functional impairment, measured by Activities of Daily Living (ADL), is a major predictor of poor outcomes in older adults. However, among patients with acute myocardial infarction (AMI), a prognostic model that incorporates ADL status is lacking. This study aimed to develop and validate such a model for predicting one-year mortality in older adults with AMI.Patients and Methods: This study included 43,308 AMI patients admitted to the Tianjin Health and Medical Big Data Superplatform from January 2010 to March 2024. Patients were categorized by Barthel Index into ADL normal (n=41,312), mildly impaired ADL (n=1,318), moderately impaired ADL (n=452), and severely impaired ADL (n=226). The cohort was randomly split 7:3 for model development and validation. A nomogram for 1-year all-cause mortality was constructed using predictors identified by Lasso regression, with model performance evaluated through receiver operating characteristic curve (ROC), decision curve analysis (DCA), and calibration curve.Results: Baseline characteristics revealed that with increasing ADL impairment, patients were significantly older [median (IQR): 73· 0 (68· 0-78· 0) vs 78· 0 (73· 0-83· 0) vs 79· 0 (73· ... |