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Newsletter | South Central MIRECC

Banner of the SC MIRECC communique newsletter

Fall 2019, Volume 21, Issue 4 - In this Issue

Meet the New Fellows
RtoP | Wearable Sensors for Assessing Frailty in Homebound Older Adults
Fall Stakeholder Forum
Highlights from Our Anchor Sites
New and Updated Clinical Education Products are Resources for CBT, Relaxation, Problem Gambling, and Veteran Wellness
Recent Publications
Pilot Study Grant Opportunity for VISN 16 and San Antonio Researchers
Research Methods and Analysis Consultation Services Available for VISN 16 and San Antonio Investigators

Research to Practice | Wearable Sensors for Assessing Frailty in Homebound Older Adults

Summary by Sonora Hudson, MA and Darius B. Dawson, PhD

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Findings of an observational cohort study by South Central MIRECC, VA and Baylor College of Medicine researchers suggest that wearable technology can provide a means of assessing prefrailty in older adults, via daily monitoring at home. Determining older adults at risk for frailty (the prefrail) in a timely manner could allow opportunities for intervention to delay adverse outcomes associated with frailty, it is hoped, without the need for time-consuming office assessment.

The study involved 153 ambulatory participants at least 60 years of age who were able to walk 15 feet and agreed to wear a pendant sensor (PAMSys™, BioSensics LLC, Watertown, MA) at the sternum for 48 hours to measure at-home physical activity and sleep quality, using chest acceleration. Individuals with severe cognitive impairment were excluded. Patients were stratified into nonfrail, prefrail and frail groups, using the Fried frailty phenotype assessment, based on five phenotypes (unintentionally losing more than 10 lbs. in the previous year, exhaustion, inactivity, slowness and decreased grip strength). Research personnel collected data of patient demographics and clinical characteristics, including history of falls, height, weight and fear of falling. In addition, the Center for Epidemiologic Studies Depression Scale was used to measure depression.

This study is novel in that few previous studies have examined specific characteristics of daily physical activity, such as activity behavior, activity postures and walking characteristics. For example, physical activity was classified as sedentary, light and moderate to vigorous, based on metabolic equivalents; and mean amplitude deviation was measured for each physical activity level. Postural parameters were calculated for resting in bed, sitting, standing, walking, and number of steps; and a previously verified algorithm was used to identify pattern changes.

The researchers noted trends for:

  • Body mass index
  • Depression
  • Fear of falling
  • Cognitive dysfunction
  • Number of prescribed medications and number of comorbidities
    • The prefrail had significantly higher BMI than the nonfrail
    • The frail had significantly higher depression than the prefrail
    • The prefrail also had lower fear of falling than the frail

Significant differences were found among the three frailty groups:

  • There was a trend of reduced standing and walking and increased duration of resting in bed with progression of frailty, for instance; and standing duration was significantly different between prefrail and nonfrail.
  • All stepping parameters declined as frailty progressed.
  • There was a trend in duration of reduced light and moderate-to-vigorous activity and increased sedentary behavior from nonfrail to frail. However, sleep quantity did not differ between the three groups.

The authors interpret the results to suggest that total sedentary duration, total moderate-to-vigorous activity duration, total walking duration as a percentage of 24-hour activities, longest unbroken walking bout, total daily steps, and longest unbroken steps were the most sensitive descriptors of prefrailty measured by the pendant sensor. Findings confirmed those of previous studies regarding total number of steps, amount of sedentary behaviors and moderate-to-vigorous activity as associated with the progression of frailty. Further work needs to examine the association between light physical activity and frailty phenotype progression.

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*MIRECC affiliates in bold

Citation: Razjouyan J, Naik AD, Horstman MJ, Kunik ME, Amirmazaheri M, Zhou H, . . . Najafi B. (2018). Wearable sensors and the assessment of frailty among vulnerable older adults: An observational cohort study. Sensors, 18, E1336.


Last updated: October 31, 2019