Postural Transitions during Activities of Daily Living Could Identify Frailty Status: Application of Wearable Technology to Identify Frailty during Unsupervised Condition

Background: Impairment of physical function is a major indicator of frailty. Functional performance tests have been shown to be useful for identification of frailty in older adults. However, these tests are often not translatable into unsupervised and remote monitoring of frailty status at home and/or community settings. Objective: In this study, we explored daily postural transition quantified using a chest-worn wearable technology to identify frailty in community-dwelling older adults. Methods: Spontaneous daily physical activity was monitored over 24 h in 120 community-dwelling elderly (age: 78 ± 8 years) using an unobtrusive wearable sensor (PAMSys™, BioSensics LLC, Watertown, MA, USA). Participants were classified as non-frail and pre-frail/frail using Fried's criteria. A validated software package was used to identify body postures and postural transition between each independent postural activity such as sit-to-stand, stand-to-sit, stand-to-walk, and walk-to-stand. The transition from walking to sitting was further classified as quick sitting and cautious sitting based on presence/absence of a standing posture pause between sitting and walking. A general linear model univariate test was used for between-group comparison. Pearson's correlation was used to determine the association between sensor-derived parameters and age. Logistic regression model was used to identify independent predictors of frailty. Results: According to Fried's criteria, 63% of participants were pre-frail/frail. The total number of postural transitions, stand-to-walk, and walk-to-stand were, respectively, 25.2, 30.2, and 30.6% lower in the pre-frail/frail group when compared to the non-frail group (p < 0.05, Cohen's d = 0.73-0.79). Furthermore, the ratio of cautious sitting was significantly higher by 6.2% in pre-frail/frail compared to non-frail (p = 0.025, Cohen's d = 0.22). Total number of postural transitions and the ratio of cautious sitting also showed significant negative and positive correlations with age, respectively (r = -0.51 and 0.29, p < 0.05). After applying a logistic regression model, among tested parameters, walk-to-stand (odds ratio [OR] = 0.997 p = 0.013), quick sitting (OR = 1.036, p = 0.05), and age (OR = 1.073, p = 0.016) were recognized as independent variables to identify frailty status. Conclusions: This study demonstrated that daily number of specific postural transitions such as walk-to-stand and quick sitting could be used for monitoring frailty status by unsupervised monitoring of daily physical activity. Further study is warranted to explore whether tracking the daily number of specific postural transitions is also sensitive to track change in the status of frailty over time.

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Daily Physical Activity and Functional Disability Incidence in Community-Dwelling Older Adults with Chronic Pain: A Prospective Cohort Study

Pain Medicine ◽

10.1093/pm/pny263 ◽

2018 ◽

Vol 20 (9) ◽

pp. 1702-1710 ◽

Cited By ~ 4

Author(s):

Keitaro Makino ◽

Sangyoon Lee ◽

Sungchul Lee ◽

Seongryu Bae ◽

Songee Jung ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Functional Disability ◽

Community Dwelling ◽

Daily Physical Activity ◽

Activity Duration ◽

Intensity Physical Activity ◽

Physical Activity Duration ◽

Community Dwelling Older Adults

Abstract Objective This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. Design Prospective cohort study. Setting Japanese community. Subjects Of the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed. Methods Participants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence. Results Among the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02–3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16–3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97–3.05). Conclusions Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.

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The Relationship between Chronotype, Physical Activity and the Estimated Risk of Dementia in Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103701 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3701

Author(s):

Ngeemasara Thapa ◽

Boram Kim ◽

Ja-Gyeong Yang ◽

Hye-Jin Park ◽

Minwoo Jang ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Mental State ◽

Mini Mental State Examination ◽

Community Dwelling ◽

Daily Physical Activity ◽

Estimated Risk ◽

Community Dwelling Older Adults ◽

The Relationship ◽

State Examination

Our study examined the association between chronotype, daily physical activity, and the estimated risk of dementia in 170 community-dwelling older adults. Chronotype was assessed with the Horne–Östberg Morningness–Eveningness Questionnaire (MEQ). Daily physical activity (of over 3 METs) was measured with a tri-axial accelerometer. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to measure the estimated risk of dementia. The evening chronotype, low daily physical activity, and dementia were positively associated with each other. The participants with low physical activity alongside evening preference had 3.05 to 3.67 times higher estimated risk of developing dementia, and participants with low physical activity and morning preference had 1.95 to 2.26 times higher estimated risk than those with high physical activity and morning preference. Our study design does not infer causation. Nevertheless, our findings suggest that chronotype and daily physical activity are predictors of the risk of having dementia in older adults aged 70 years and above.

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The Predictive Performance of Objective Measures of Physical Activity Derived From Accelerometry Data for 5-Year All-Cause Mortality in Older Adults: National Health and Nutritional Examination Survey 2003–2006

The Journals of Gerontology Series A ◽

10.1093/gerona/glz193 ◽

2019 ◽

Vol 75 (9) ◽

pp. 1779-1785 ◽

Cited By ~ 4

Author(s):

Ekaterina Smirnova ◽

Andrew Leroux ◽

Quy Cao ◽

Lucia Tabacu ◽

Vadim Zipunnikov ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Logistic Regression ◽

National Health ◽

Predictive Performance ◽

Wearable Technology ◽

Living Environment ◽

Activity Count ◽

All Cause Mortality ◽

Nutritional Examination Survey

Abstract Background Declining physical activity (PA) is a hallmark of aging. Wearable technology provides reliable measures of the frequency, duration, intensity, and timing of PA. Accelerometry-derived measures of PA are compared with established predictors of 5-year all-cause mortality in older adults in terms of individual, relative, and combined predictive performance. Methods Participants aged between 50 and 85 years from the 2003–2006 National Health and Nutritional Examination Survey (NHANES, n = 2,978) wore a hip-worn accelerometer in the free-living environment for up to 7 days. A total of 33 predictors of 5-year all-cause mortality (number of events = 297), including 20 measures of objective PA, were compared using univariate and multivariate logistic regression. Results In univariate logistic regression, the total activity count was the best predictor of 5-year mortality (Area under the Curve (AUC) = 0.771) followed by age (AUC = 0.758). Overall, 9 of the top 10 predictors were objective PA measures (AUC from 0.771 to 0.692). In multivariate regression, the 10-fold cross-validated AUC was 0.798 for the model without objective PA variables (9 predictors) and 0.838 for the forward selection model with objective PA variables (13 predictors). The Net Reclassification Index was substantially improved by adding objective PA variables (p < .001). Conclusions Objective accelerometry-derived PA measures outperform traditional predictors of 5-year mortality, including age. This highlights the importance of wearable technology for providing reproducible, unbiased, and prognostic biomarkers of health.

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Self-organizing peer coach groups to increase daily physical activity in community dwelling older adults

Preventive Medicine Reports ◽

10.1016/j.pmedr.2020.101181 ◽

2020 ◽

Vol 20 ◽

pp. 101181 ◽

Cited By ~ 1

Author(s):

Paul van de Vijver ◽

Frank Schalkwijk ◽

Mattijs E Numans ◽

Joris P.J. Slaets ◽

David van Bodegom

Keyword(s):

Physical Activity ◽

Older Adults ◽

Community Dwelling ◽

Daily Physical Activity ◽

Peer Coach ◽

Community Dwelling Older Adults ◽

Self Organizing

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Aplicación de modelos de regresión logística en metodología observacional: modalidades de competición en la iniciación al fútbol.

Anales de Psicología ◽

10.6018/analesps.32.1.186951 ◽

2015 ◽

Vol 32 (1) ◽

pp. 288 ◽

Cited By ~ 2

Author(s):

Daniel Lapresa ◽

Javier Arana ◽

M.Teresa Anguera ◽

J.Ignacio Pérez-Castellanos ◽

Mario Amatria

Keyword(s):

Physical Activity ◽

Logistic Regression ◽

Regression Model ◽

Regression Models ◽

Logistic Regression Model ◽

Multiple Logistic Regression ◽

Observational Methodology ◽

Logistic Regression Models ◽

Game Format ◽

Simple Logistic

This study shows how simple and multiple logistic regression can be used in observational methodology and more specifically, in the fields of physical activity and sport. We demonstrate this in a study designed to determine whether three-a-side futsal or five-a-side futsal is more suited to the needs and potential of children aged 6-to-8 years. We constructed a multiple logistic regression model to analyze use of space (depth of play) and three simple logistic regression models to determine which game format is more likely to potentiate effective technical and tactical performance.

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Is there an association between ageist attitudes and frailty?

BMC Geriatrics ◽

10.1186/s12877-019-1357-y ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Douglas Salguero ◽

Juliana Ferri-Guerra ◽

Nadeem Y. Mohammed ◽

Dhanya Baskaran ◽

Raquel Aparicio-Ugarriza ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Multinomial Logistic Regression ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Outcome Variable ◽

Cross Sectional ◽

Logistic Regression Models ◽

Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

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Home Invasion Homicide Offenders: An Analysis of Subsequent Prison Rule Violations

Violence and Victims ◽

10.1891/0886-6708.vv-d-14-00043 ◽

2015 ◽

Vol 30 (6) ◽

pp. 1082-1098 ◽

Cited By ~ 2

Author(s):

Jonathan Sorensen ◽

Heidi Bonner ◽

Shelley Visconte ◽

Mark Vigen ◽

S. O. Woods

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Regression Model ◽

Logistic Regression Model ◽

Small Body ◽

Behavior Based

This study adds to the small body of research on home invasion by describing the circumstances surrounding home invasions that resulted in the death of a resident. The 2 most common types of home invasion homicides (HIHs) involved “drug ripoffs” and robberies of older adults for money and property. The study also examined subsequent rule-violating behavior of 132 HIH inmates while incarcerated. The rate of rule violations among HIH inmates was similar to a broader cohort of incarcerated homicide offenders. A logistic regression model identified variation in assaultive prison behavior based on some routine predictors (age, education, race, and prior imprisonment) and 2 associated with the crime (method of killing and age by gender of victims).

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Total Daily Physical Activity and the Risk of Parkinsonism in Community-Dwelling Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glz111 ◽

2019 ◽

Vol 75 (4) ◽

pp. 702-711 ◽

Cited By ~ 2

Author(s):

Shahram Oveisgharan ◽

Lei Yu ◽

Robert J Dawe ◽

David A Bennett ◽

Aron S Buchman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Mixed Effects ◽

Community Dwelling ◽

Daily Physical Activity ◽

Active Lifestyle ◽

Cox Models ◽

Linear Mixed Effects ◽

Community Dwelling Older Adults ◽

Reduced Risk

Abstract Background Physical activity is a modifiable risk factor associated with health benefits. We hypothesized that a more active lifestyle in older adults is associated with a reduced risk of incident parkinsonism and a slower rate of its progression. Methods Total daily physical activity was recorded with an activity monitor in 889 community-dwelling older adults participating in the Rush Memory and Aging Project. Four parkinsonian signs were assessed with a modified motor portion of the Unified Parkinson’s Disease Rating Scale and summarized as a categorical measure and continuous global parkinsonian score. We used Cox models to determine whether physical activity was associated with incident parkinsonism and linear mixed-effects models to examine if physical activity was associated with the rate of progressive parkinsonism. Results During an average follow-up of 4 years, 233 of 682 (34%) participants, without parkinsonism, developed incident parkinsonism. In Cox models controlling for age, sex, and education, a higher level of physical activity was associated with a reduced risk of developing parkinsonism (hazard ratio = 0.79; 95% CI = 0.70–0.88, p < .001). This association was not attenuated when controlling for cognition, depressive symptoms, Apolipoprotein E ℇ4 allele, and chronic health conditions. In a linear mixed-effects model including all participants (N = 889) which controlled for age, sex, and education, a 1 SD total daily physical activity was associated with a 20% slower rate of progression of parkinsonism. Conclusion Older adults with a more active lifestyle have a reduced risk for parkinsonism and a slower rate of its progression.

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Daily Physical Activity in Older Age

GeroPsych ◽

10.1024/1662-9647/a000255 ◽

2021 ◽

pp. 1-11

Author(s):

Lea O. Wilhelm ◽

Theresa Pauly ◽

Maureen C. Ashe ◽

Christiane A. Hoppmann

Keyword(s):

Physical Activity ◽

Older Adults ◽

Negative Affect ◽

Multilevel Models ◽

Fear Of Falling ◽

Community Dwelling ◽

Daily Physical Activity ◽

Older Age ◽

Time Varying ◽

Subjective Experiences

Abstract. Affective barriers like negative affect (time-varying subjective state) or fear of falling (person-trait) may reduce daily physical activity among older adults. A group of 123 community-dwelling older adults ( Mage = 71.83, range = 64–85, 63% women) from Canada participated in a 10-day time-sampling study. We used accelerometer-assessed physical activity, assessing negative affect three times per day and fear of falling once prior to the 10-day period. Using multilevel models, we noted considerable variability in physical activity between days (activity counts: 47%; steps: 55%). We found time-varying negative associations between daily physical activity and daily negative affect. Fear of falling was not related to daily physical activity. Findings point to the merit of examining time-varying differences in subjective experiences when looking for physical activity barriers in older age.

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