Predicting Frailty in Older Adults Using Wearable Technology

A recent study conducted by researchers at Brigham and Women’s Hospital has shed light on the potential of wearable devices to forecast the onset of frailty in older individuals. By monitoring circadian rest-activity rhythms, these devices have shown promise in identifying early signs of frailty, thereby paving the way for proactive health monitoring and intervention.

The study, which involved analyzing data from more than 1,000 adults, established a clear connection between disrupted rest-activity patterns and an elevated risk of frailty, as well as an accelerated progression of this condition. This finding underscores the significance of wearable technology in the realm of early health assessment and intervention.

The research, conducted by experts from Brigham and Women’s Hospital, a prominent member of the Mass General Brigham healthcare system, demonstrates that wearable devices possess the potential to aid in the prediction of health complications related to frailty in older adults. The study’s primary focus was on disturbances in daily rest and activity patterns, known as circadian rest-activity rhythms, which were captured by wearable devices. Astonishingly, in some cases, these devices detected variations indicative of future frailty more than six years before its actual onset. These groundbreaking results have been published in the esteemed journal Nature Communications on November 16.

Lead author Ruixue Cai, a doctoral candidate in the Division of Sleep and Circadian Disorders, emphasized the significance of these findings, stating, “Our study demonstrates that wearable devices could represent an important tool for long-term health monitoring in older adults. Frailty can reduce quality of life, and detecting it early or predicting who is at risk could help us intervene to promote healthy aging.”

Frailty, characterized by a decline in physiological function associated with aging, is a common condition among older populations. It renders individuals more susceptible to adverse health outcomes. The study also highlighted the link between disrupted circadian rest-activity rhythms and neurodegenerative diseases such as Alzheimer’s and Parkinson’s. Additionally, the research recognized that as people age, their rest-activity patterns change, with older individuals often preferring earlier hours compared to their younger counterparts.

The study involved a cohort of 1,022 adults, with an average age of 81, who were part of the Rush Memory and Aging Project. These participants were followed annually for up to 16 years, and their continuous rest and activity data from wearable devices were analyzed. The research considered various measures, including the amplitude, stability, and variability of these circadian rhythms.

During an average follow-up period of over six and a half years, 357 participants developed frailty. The study revealed that individuals with blunted, less robust, or inconsistent rest-activity patterns faced a higher risk of frailty incidence. Furthermore, these disturbances correlated with a more rapid deterioration in frailty progression, including a decrease in grip strength, reduction in body mass index, and increased fatigue. These findings remained consistent even after accounting for factors such as age, sex, sleep duration, sleep fragmentation, and cardiovascular dysfunction.

It is important to acknowledge certain limitations in the study. The participants were primarily older individuals, with an average age exceeding 80. Rest-activity patterns can be influenced by seasonal variations and environmental conditions, and wearable devices may occasionally misinterpret sleep and wake cycles. To establish a causal link between circadian disturbances and frailty, future research should include more precise sleep assessments.

In conclusion, wearable technology has emerged as a comprehensive approach to detecting early indicators of disease. Combining circadian rest-activity data with other clinical measures holds promise for the early identification and intervention in populations vulnerable to frailty. This research represents a significant step forward in enhancing the quality of life for older adults by enabling timely interventions and promoting healthy aging.

Reference: “Circadian disturbances and frailty risk in older adults” by Ruixue Cai, Lei Gao, Chenlu Gao, Lei Yu, Xi Zheng, David A. Bennett, Aron S. Buchman, Kun Hu and Peng Li, 16 November 2023, Nature Communications.
DOI: 10.1038/s41467-023-42727-z

Authorship: Additional Mass General Brigham co-authors include Lei Gao (MGH, BWH), Chenlu Gao (BWH, MGH), Xi Zheng (BWH) and Kun Hu (BWH, MGH). Other authors include Lei Yu, David A. Bennett, and Aron S. Buchman, Rush University Medical Center.

Funding: This work is supported by grants from the NIH, the BrightFocus Foundation Alzheimer’s Research Program and the Brigham Research Institute’s Fund to Sustain Research Excellence Program.

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More about Frailty Prediction

• Nature Communications Article
• Brigham and Women’s Hospital
• Mass General Brigham
• Rush Memory and Aging Project
• NIH (National Institutes of Health)
• BrightFocus Foundation Alzheimer’s Research Program
• Brigham Research Institute