scholarly journals Sensor-based Characterization of Daily Walking: A New Paradigm in Pre-frailty/Frailty Assessment

2020 ◽  
Author(s):  
Danya Pradeep Kumar ◽  
Nima Toosizadeh ◽  
Jane Mohler ◽  
Hossein Ehsani ◽  
Cassidy Mannier ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Models ◽  
Gait Variability ◽  
Geriatric Syndrome ◽  
Performance Parameters ◽  
New Paradigm ◽  
Gait Performance ◽  
Critical Elements ◽  
Frailty Assessment

Abstract Background: Frailty is a highly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is one of the major indicators of frailty. Objective: The goal of this study was to evaluate an algorithm that discriminates between frailty groups (non-frail and pre-frail/frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA). Methods: DPA was acquired for 48 hours from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Continuous bouts of walking for 20s, 30s, 40s, 50s and 60s without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables. Results: 126 older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and continuous walking quantitative measures were significantly different between non-frail and pre-frail/frail groups (p<0.05). Among the five different durations (20s, 30s, 40s, 50s and 60s), gait performance parameters extracted from 60s continuous walks provided the best frailty assessment results. Using the 60s gait performance parameters in the logistic model, pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity. Discussion: Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty.

scholarly journals Sensor-based Characterization of Daily Walking: A New Paradigm in Pre-frailty/Frailty Assessment

2020 ◽  
Author(s):  
Danya Pradeep Kumar ◽  
Nima Toosizadeh ◽  
Jane Mohler ◽  
Hossein Ehsani ◽  
Cassidy Mannier ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Models ◽  
Gait Variability ◽  
Geriatric Syndrome ◽  
Performance Parameters ◽  
New Paradigm ◽  
Gait Performance ◽  
Critical Elements ◽  
Frailty Assessment

Abstract Background: Frailty is a highly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is one of the major indicators of frailty. The goal of this study was to evaluate an algorithm that discriminates between frailty groups (non-frail and pre-frail/frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA). Methods: DPA was acquired for 48 hours from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Continuous bouts of walking for 20s, 30s, 40s, 50s and 60s without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables. Results: 126 older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and continuous walking quantitative measures were significantly different between non-frail and pre-frail/frail groups (p<0.05). Among the five different durations (20s, 30s, 40s, 50s and 60s), gait performance parameters extracted from 60s continuous walks provided the best frailty assessment results. Using the 60s gait performance parameters in the logistic model, pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity. Discussion: Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty.Trial registration: The clinical trial was retrospectively registered on June 18th, 2013 with ClinicalTrials.gov, identifier NCT01880229.

scholarly journals Sensor-based Characterization of Daily Walking: A New Paradigm in Pre-frailty/Frailty Assessment

2020 ◽  
Author(s):  
Danya Pradeep Kumar ◽  
Nima Toosizadeh ◽  
Jane Mohler ◽  
Hossein Ehsani ◽  
Cassidy Mannier ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Models ◽  
Gait Variability ◽  
Geriatric Syndrome ◽  
Performance Parameters ◽  
New Paradigm ◽  
Gait Performance ◽  
Critical Elements ◽  
Frailty Assessment

Abstract Background : Frailty is a highly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is one of the major indicators of frailty. The goal of this study was to evaluate an algorithm that discriminates between frailty groups (non-frail and pre-frail/frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA). Methods : DPA was acquired for 48 hours from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Continuous bouts of walking for 20s, 30s, 40s, 50s and 60s without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables. Results : 126 older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and continuous walking quantitative measures were significantly different between non-frail and pre-frail/frail groups ( p <0.05). Among the five different durations (20s, 30s, 40s, 50s and 60s), gait performance parameters extracted from 60s continuous walks provided the best frailty assessment results. Using the 60s gait performance parameters in the logistic model, pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity. Discussion : Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty.

Sensor-based Characterization of Daily Walking: A New Paradigm in Frailty Assessment

2019 ◽  
Author(s):  
Danya Pradeep Kumar ◽  
Nima Toosizadeh ◽  
Jane Mohler ◽  
Hossein Ehsani ◽  
Kaveh Laksari
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Models ◽  
Gait Variability ◽  
Geriatric Syndrome ◽  
Performance Parameters ◽  
New Paradigm ◽  
Gait Performance ◽  
Critical Elements ◽  
Acceleration Data

Abstract Background Frailty is an increasingly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is a prime indicator of frailty.Objective The goal of this study was to develop an algorithm that discriminates between frailty groups (non-frail, pre-frail, and frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA).Methods DPA was acquired for 48 hours from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Purposeful continuous bouts of walking (≥60s) without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables.Results 126 older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and purposeful walking quantitative measures were significantly different between non-frail and pre-frail as well as non-frail and frail groups ( p <0.05). Using the logistic model pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity.Discussion Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty.

scholarly journals FRAILTY ASSESSMENT BASED ON THE QUALITY OF DAILY WALKING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S85-S85 ◽  
Author(s):  
Danya Pradeep Kumar ◽  
Nima Toosizadeh ◽  
Jane Mohler ◽  
Kaveh Laksari
Keyword(s):  
Physical Activity ◽  
Gait Analysis ◽  
Logistic Models ◽  
Gait Variability ◽  
Geriatric Syndrome ◽  
Age Related ◽  
Power Spectral ◽  
Gait Parameters ◽  
Clinical Gait Analysis

Abstract Frailty is an increasingly recognized geriatric syndrome resulting in age-related decline in reserve across multiple physiologic systems. An impaired physical function is a prime indicator of frailty. In this study, we aim to implement a body-worn sensor to characterize the quantity and quality of everyday walking, and establish associations between gait impairment and frailty. Daily physical activity was acquired for 48 hours from 125 older adults (≥65 years; 44 non-frail, 60 pre-frail, and 21 frail based on the Fried gold standard) using a tri-axial accelerometer motion-sensor. Continuous purposeful walks (≥60s) without pauses were identified from time-domain acceleration data. Power spectral density (PSD) analysis was performed to define higher gait variability, which was identified by a shorter and wider PSD peak. Association between frailty and gait parameters was assessed using multivariable nominal logistic models with frailty as the dependent variable, and demographic parameters along with the gait parameters as the independent variables. Stride times, PSD gait variability, and total and maximum continuous purposeful walking duration were significantly different between non-frail and pre-frail/frail groups (p&lt;0.05). Using a step-wise model with the above qualitative and quantitative gait parameters as predictors, the pre-frail/frail group (vs. non-frail) was identified with 71.4% sensitivity and 75.4% specificity. Everyday walking characteristics were found to be accurate determinants of frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the stages of frailty. In-home gait analysis is advantageous over clinical gait analysis as it enables cost- and space-effective continuous monitoring.

Neighborhood Influences on Physical Activity in Middle-Aged and Older Adults: A Multilevel Perspective

2005 ◽  
Vol 13 (1) ◽  
pp. 87-114 ◽  
Author(s):  
Fuzhong Li ◽  
K. John Fisher ◽  
Adrian Bauman ◽  
Marcia G. Ory ◽  
Wojtek Chodzko-Zajko ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Activity Behavior ◽  
Research Literature ◽  
Middle Aged ◽  
New Paradigm ◽  
Individual Level ◽  
Neighborhood Influences ◽  
Environment Variables ◽  
Multilevel Perspective

Over the past few years, attention has been drawn to the importance of neighborhood influences on physical activity behavior and the need to consider a multilevel analysis involving not only individual-level variables but also social-and physical-environment variables at the neighborhood level in explaining individual differences in physical activity outcomes. This new paradigm raises a series of issues concerning systems of influence observed at different hierarchical levels (e.g., individuals, neighborhoods) and variables that can be defined at each level. This article reviews research literature and discusses substantive, operational, and statistical issues in studies involving multilevel influences on middle-aged and older adults’ physical activity. To encourage multilevel research, the authors propose a model that focuses attention on multiple levels of influence and the interaction among variables characterizing individuals, among variables characterizing neighborhoods, and across both levels. They conclude that a multilevel perspective is needed to increase understanding of the multiple influences on physical activity.

A Mediterranean lifestyle and frailty incidence in older adults: the Seniors-ENRICA-1 cohort

2021 ◽  
Author(s):  
Javier Maroto-Rodriguez ◽  
Mario Delgado-Velandia ◽  
Rosario Ortolá ◽  
Esther García-Esquinas ◽  
David Martinez-Gomez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Lower Risk ◽  
Dietary Habits ◽  
Joint Effect ◽  
Geriatric Syndrome ◽  
Logistic Regression Models ◽  
Social Habits ◽  
Diet And Lifestyle

Abstract Background Frailty is a geriatric syndrome that entails high risk of hospitalization, disability, and death. While adherence to Mediterranean diet has been associated with lower risk of frailty, the joint effect of diet and lifestyle is uncertain. This study examined the association between a Mediterranean lifestyle (diet, customs, and traditions) and frailty incidence in older adults. Methods We analyzed data from 1,880 individuals aged ≥ 60 from the prospective Seniors-ENRICA-1 cohort. Adherence to the Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (higher scores representing better adherence), divided into three blocks: 1) “Mediterranean food consumption”, 2) “Mediterranean dietary habits” (practices around meals)” and 3) “Physical activity, rest, social habits and conviviality”. Frailty was ascertained as the presence of ≥ 3 of the 5 Fried criteria: a) Exhaustion; b) Muscle weakness; c) Low physical activity; d) Slow walking speed; e) Unintentional weight loss. Main statistical analyses were performed using logistic regression models, adjusting for the main confounders. Results After a 3.3-y follow-up, 136 incident frailty cases were ascertained. Compared with participants in the lowest tertile of the MEDLIFE score, the OR (95% CI) for frailty was 0.88 (0.58–1.34) for the second tertile, and 0.38 (0.21–0.69) for the third tertile (p-trend = 0.003). Blocks 1 and 3 of the MEDLIFE score were independently associated with lower frailty risk. Most items within these blocks showed a tendency to reduced frailty. Conclusions Higher adherence to a Mediterranean lifestyle was associated with lower risk of frailty.

scholarly journals Frailty Assessment Using a Novel Approach Based on Combined Motor and Cardiac Functions: A Pilot Study

2021 ◽  
Author(s):  
Nima Toosizadeh ◽  
Maryam Eskandari ◽  
Hossein Ehsani ◽  
Saman Parvaneh ◽  
Mehran Asghari ◽  
...  
Keyword(s):  
Older Adults ◽  
Strong Association ◽  
Logistic Models ◽  
Elbow Flexion ◽  
Percentage Increase ◽  
Left Chest ◽  
Percentage Decrease ◽  
Time To Peak ◽  
Frailty Assessment ◽  
Novel Approach

Abstract Background: Previous research showed association between frailty and an impaired autonomic nervous system; however, the direct effect of frailty on heart rate (HR) behavior during physical activity is unclear. The purpose of the current study was to determine the association between HR increase and decrease with frailty during a localized upper-extremity function (UEF) task to establish a multimodal frailty test. Methods: Older adults aged 65 or older were recruited and performed the UEF task of rapid elbow flexion for 20 seconds with the right arm. Wearable gyroscopes were used to measure forearm and upper-arm motion, and electrocardiography were recorded using leads on the left chest. Using this setup, HR dynamics were measured, including time to peak HR, recovery time, percentage increase in HR during UEF, and percentage decrease in HR during recovery after UEF. Results: Fifty-six eligible participants were recruited, including 12 non-frail (age=76.92±7.32 years), and 44 pre-frail/frail (age=81.23±8.14 years). Analysis of variance models showed that the percentage increase in HR during UEF and percentage decrease in HR during recovery were both 47% smaller in pre-frail/frail older adults compared to non-frails (p<0.01, effect size = 1.42 and 1.17 for increase and decrease percentages). Using logistic models with both UEF kinematics and HR parameters as independent variables, frailty was predicted with a sensitivity of 0.82 and specificity of 0.83. Conclusion: Current findings showed evidence of strong association between HR dynamics and frailty. It is suggested that combining kinematics and HR data in a multimodal model may provide a promising objective tool for frailty assessment.

scholarly journals Muscle Strength, Physical Activity, and Functional Limitations in Older Adults with Central Obesity

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Cassandra M. Germain ◽  
John A. Batsis ◽  
Elizabeth Vasquez ◽  
Douglas R. McQuoid
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Muscle Strength ◽  
Grip Strength ◽  
Functional Impairment ◽  
Central Obesity ◽  
Functional Limitations ◽  
Logistic Models ◽  
Community Dwelling ◽  
Increased Risk

Background.Obesity and muscle weakness are independently associated with increased risk of physical and functional impairment in older adults. It is unknown whether physical activity (PA) and muscle strength combined provide added protection against functional impairment. This study examines the association between muscle strength, PA, and functional outcomes in older adults with central obesity.Methods.Prevalence and odds of physical (PL), ADL, and IADL limitation were calculated for 6,388 community dwelling adults aged ≥ 60 with central obesity. Individuals were stratified by sex-specific hand grip tertiles and PA. Logistic models were adjusted for age, education, comorbidities, and body-mass index and weighted.Results.Overall prevalence of PL and ADL and IADL limitations were progressively lower by grip category. Within grip categories, prevalence was lower for individuals who were active than those who were inactive. Adjusted models showed significantly lower odds of PL OR 0.42 [0.31, 0.56]; ADL OR 0.60 [0.43, 0.84], and IADL OR 0.46[0.35, 0.61] for those in the highest grip strength category as compared to those in the lowest grip category.Conclusion.Improving grip strength in obese elders who are not able to engage in traditional exercise is important for reducing odds of physical and functional impairment.

Obstacle Negotiation, Gait Variability, and Risk of Falling: Results From the “Gait and Brain Study”

2018 ◽  
Vol 74 (9) ◽  
pp. 1422-1428 ◽  
Author(s):  
Frederico Pieruccini-Faria ◽  
Manuel Montero-Odasso
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Fear Of Falling ◽  
Gait Variability ◽  
Time Variability ◽  
Older Individuals ◽  
Risk Of Falling ◽  
Obstacle Crossing ◽  
Gait Performance ◽  
Brain Study

Abstract Background Gait variability is an early fall predictor. However, it is unknown how gait variability of older adults at high risk of falls is affected by an obstacle negotiation task. We aimed to compare gait performance between older adults with significant history of falls (i.e. fallers) and nonfallers while approaching an obstacle crossing. Methods A total of 137 older adults without dementia were enrolled (72.7 ± 5.1 years of age; 60.5% women) from the “Gait and Brain Study.” Fallers were defined as having at least one injurious fall or at least two noninjurious falls in the previous 12 months. Participants performed gait assessments under unobstructed and obstructed conditions. During the obstructed condition, participants walked and stepped over an ad hoc obstacle set at 15% of participants’ height, transversally placed on a 6-meter electronic walkway. Gait speed and step-to-step variabilities were quantified from the last six steps prior to obstacle crossing. Analysis of variance models adjusted for age, sex, fear of falling, comorbidities, and unobstructed gait were used to compare gait performance of fallers and nonfallers during an obstacle approaching. Results In the study, 27 older adults were identified as fallers and 110 as nonfallers. Fallers had higher step time variability and step length variability when approaching an obstacle compared with nonfallers, although groups had comparable gait performance during unobstructed walking. Conclusion Gait variability of older individuals at high risk of falling is more disturbed, compared with low-risk individuals, while approaching an obstacle crossing. High gait variability prior to crossing an obstacle may be a risk factor for falls.

scholarly journals The role of exercise and physical activity on aging-related diseases and geriatric syndromes

2022 ◽  
Vol 11 ◽  
pp. 6
Author(s):  
Mehdi Kushkestani ◽  
Mohsen Parvani ◽  
Mahmood Ghafari ◽  
Zahra Avazpoor
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Population Aging ◽  
Low Cost ◽  
Premature Death ◽  
Current Evidence ◽  
Geriatric Syndrome ◽  
Geriatric Syndromes ◽  
Public Health Burden

Aging is a complex process of physiological and social changes that leads to various diseases. The number of elderly people in the world is increasing dramatically and it should be noted that rapid population aging represents a major public health burden. On the other hand, providing an appropriate and low-cost approach to control and prevent complications such as chronic diseases, physical dysfunction, and the geriatric syndrome is necessary. Also, numerous studies have shown that participation in physical activity and exercise training reduces the incidence of dysfunctional capacity, cardiovascular and metabolic disease, as well as the premature death rate in older adults. After plenty of precise observations about the role of exercise on aging-related diseases and geriatric syndromes articles, the benefits of exercise and physical activity in older adults will be more tangible. Therefore, the first purpose of the present review was to investigate the mechanisms of PA and exercises that are involved in the prevention of aging-related diseases and GS using current evidence (from 2015 onwards). Also, the purpose of this study was to provide an exercise guideline (aerobic and resistance training) based on recent evidence (from 2015 onwards). El envejecimiento es un proceso complejo de cambios fisiológicos y sociales que conduce a diversas enfermedades. El número de personas de edad avanzada en el mundo está aumentando drásticamente y cabe señalar que el rápido envejecimiento de la población representa una importante carga para la salud pública. Por otro lado, es necesario brindar un enfoque adecuado y de bajo costo para controlar y prevenir complicaciones como enfermedades crónicas, disfunción física y síndrome geriátrico. Además, numerosos estudios han demostrado que la participación en la actividad física y el entrenamiento físico reduce la incidencia de disfunciones, enfermedades cardiovasculares y metabólicas, así como la tasa de muerte prematura en los adultos mayores. Después de muchas observaciones precisas sobre el papel del ejercicio en los artículos sobre enfermedades relacionadas con el envejecimiento y síndromes geriátricos, los beneficios del ejercicio y la actividad física en los adultos mayores serán más tangibles. Por lo tanto, el primer propósito de la presente revisión fue investigar los mecanismos de actividad física y ejercicios que están involucrados en la prevención de enfermedades relacionadas con el envejecimiento y síndrome geriátrico utilizando la evidencia actual (de 2015 en adelante). Además, el propósito de este estudio fue proporcionar una guía de ejercicio (entrenamiento aeróbico y de resistencia) basada en evidencia reciente (de 2015 en adelante).

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