AUTHOR=Bae Jun-Hyun , Seo Ji-won , Kim Dae Young TITLE=Deep-learning model for predicting physical fitness in possible sarcopenia: analysis of the Korean physical fitness award from 2010 to 2023 JOURNAL=Frontiers in Public Health VOLUME=Volume 11 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1241388 DOI=10.3389/fpubh.2023.1241388 ISSN=2296-2565 ABSTRACT=Introduction: Physical fitness is regarded as a significant indicator of sarcopenia. This study aimed to develop and evaluate a deep-learning model for predicting the decline in physical fitness due to sarcopenia in individuals with potential sarcopenia.This study used the 2010-2023 Korean National Physical Fitness Award data. The data comprised exercise-and health-related measurements in Koreans aged >65 years and included body composition and physical fitness variables. Appendicular muscle mass (ASM) was calculated as ASM/height 2 to define normal and possible sarcopenia. The deep-learning model was created with EarlyStopping and ModelCheckpoint to prevent overfitting and was evaluated using stratified k-fold cross-validation (k = 5). The model was trained and tested using training data and validation data from each fold. The model's performance was assessed using a confusion matrix, receiver operating characteristic curve, and area under the curve. The average performance metrics obtained from each cross-validation were determined. For the analysis of feature importance, SHAP, permutation feature importance, and LIME were employed as model-agnostic explanation methods. This is a provisional file, not the final typeset articleThe deep-learning model proved effective in distinguishing from sarcopenia, with an accuracy of 87.55%, precision of 85.57%, recall of 90.34%, and F1 score of 87.89%. Waist circumference (WC, cm), absolute grip strength (kg), and body fat (BF, %) had an influence on the model output. SHAP, LIME, and permutation feature importance analyses revealed that WC and absolute grip strength were the most important variables. WC, figure-of-8 walk, BF, timed up-andgo, and sit-and-reach emerged as key factors for predicting possible sarcopenia.The deep-learning model showed high accuracy and recall with respect to possible sarcopenia prediction. Considering the need for the development of a more detailed and accurate sarcopenia prediction model, the study findings hold promise for enhancing sarcopenia prediction using deep learning.