Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 6, 2024
Date Accepted: Sep 5, 2024
Can Heart Rate Recovery and Gait Kinetics in a Single Wearable Predict Frailty: A Pilot Study
ABSTRACT
Background:
Aging is a risk factor for falls, frailty, and disability. The utility of wearables to screen for physical performance and frailty at population level is an emerging research area. To date there are a limited number of devices which can measure frailty and physical performance simultaneously.
Objective:
The aim of this study is to evaluate accuracy and validity of a continuous digital monitoring wearable device incorporating gait kinetics and heart rate recovery measurement in detecting frailty, poor physical performance and falls risk in older adults at risk of falls.
Methods:
This is a sub-study of community dwelling older adults ≥ 60-year-old with falls or near falls in the past 12 months recruited for falls prevention intervention study. 22 participants agreed to have wearables worn on their ankles. Interview questionnaire was administered on demographics, cognition, frailty (FRAIL), physical function, and Falls Risk for Older People in the Community (FROP-Com). Physical performance comprised of gait speed, Timed-Up-and-Go (TUG) and Short Physical Performance Battery test (SPPB). Gait Analyzer was used to provide measurement of gait kinetics, steps and FRAIL-functional domain (fatigue, resistance and aerobic). Heart-rate Analyzer was used for evaluation of heart rate recovery and as a measure of FRAIL-non-functional domain (weight loss and chronic illness).
Results:
The mean age was 74.6 years, 13.6% were frail and 45.5% were pre-frail. The respective sensitivity (Sn), specificity (Sp) and area under the curve (AUC) for Gait Analyzer against functional domains were i) SPPB (balance and gait): 1.00; 0.84 and 0.92 ii) FRAIL-functional: 0.38, 0.89 and 0.64 iii) FROP-com: 0.45, 0.91 and 0.68 iv) Gait speed: 0.60, 1.00 and 0.80 and v) TUG 1.00, 0.94 and 0.97 respectively. Heart-rate Analyzer demonstrated superior validity for non-functional component of frailty with Sn, Sp and AUC of 1.00, 0.73 and 0.83 respectively.
Conclusions:
Gait- and Heart-rate Analyzer had significant agreement with functional component of FRAIL scale, gait speed and FROP-com. In addition, Heart-rate Analyzer also showed significant agreement with the non-functional component of FRAIL scale. The Gait and HR Analyzer could be deployed as a screening test for frailty and falls in the community dwelling older adults but requires further improvisation and validation at the population level. Clinical Trial: NA
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